Anthropometric, physiological and biochemical parameters in relation to perceived stress and lifestyle diseases among correctional services staff in the Amathole Region, Eastern Cape, South Africa
- Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
- Date Issued: 2020-01
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
- Date Issued: 2020-01
Antibacterial activities of both combined and individual medicinal plants extracts traditionally used to treat pneumonia
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
- Authors: Mhango, Immaculate
- Date: 2017
- Subjects: Antibacterial agents , Pneumonia -- Treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19762 , vital:28959
- Description: Pneumonia is one of the five major leading causes of death in children under-fives years and the elderly worldwide. Antibiotics used for its treatment are less potent due to bacteria development of bacteria resistant to antibiotics. This has led to a surge in search of novel drugs. There are already some drugs in clinical use that have natural products and derivatives such as quinine, morphine, vincristine, and taxol among others. The healing value of medicinal plants has been well accepted since Stone Age across the globe. This plant therapy has been prescribed and prepared independently or in combination. The following plants: Terminalia sericea, Warburgia salutaris, Dodonea angustofolia, Eucalyptus camaldulensis, Ballota africana, Kigelia africana and Acorus gramineus. These plants are most commonly used for treatment of pneumonia and other ailment, were studied to validate their antimicrobial activity based on scientific determination. The primary aim of this study was to evaluate the efficacy of these plants against bacteria pneumonia pathogens. Seven medicinal plants, independently and in combinations were relatively analysed for their antimicrobial activity against Staphylococcus aureus, Streptococcus pyogenes, and Klebsiella pneumoniae. Ground plant material of roots, bark and leafs were prepared with acetone, ethanol and distilled water. Dimethyl sulfoxide (10 &100%) was used as a reconstitution solvent and ciprofloxacin (10 %) as a positive control. The antimicrobial efficacy was determined using agar well diffusion and microtiter plate methods. Interaction between plants was evaluated by calculating fraction inhibitory concentration index (ΣFIC). Noteworthy activity for individual studies with all test organisms was observed with T. sericea. However, highest ZOI (30 mm) was observed for B. africana ethanol extract for S. pyogenes. Weak microbial activity was noted in W. salutaris and D. angustofolia extracts with all test organisms. Good antimicrobial activity was observed in combination studies with all organisms. The potency of different plant combinations varied with highest ZOI observed with B. africana and W. salutaris ranging from 33-35 mm, conversely ZOI of 35 mm was also noted for S. aureus in B. africana and E. camaldulensis ethanol extract. Noteworthy antimicrobial activity was observed in T. sericea and D. angustofolia against all test pathogens. weak antimicrobial activity with highest MICs was observed in combinations where W. salutaris was involved. After calculating ΣFICs, strongest synergistic effect was displayed for W. salutaris and D. angustofolia against all test organisms (lowest ΣFICs 0.0491). Most plant extract combinations, displayed either synergistic, additive or indifferent effect, with few demonstrating antagonistic interactions. Significant antagonism effect was noted for S. pyogenes with T. sericea ethanol extract ΣFIC value of 15.51. Based on results of this study use of plants in combination increase antimicrobial efficacy. The antimicrobial activities; synergistic and additive effects observed adds credibility in the use of plant combination for therapeutic value in treatment of pneumonia. Future studies are recommended to identify and isolate specific active compounds involved in plant combination interactions. The importance of combination studies for possible development of new antimicrobials that can succumb bacterial resistance need to be highlighted.
- Full Text:
- Date Issued: 2017
Antibacterial activity of liposome encapsulated cyclo(TYR-PRO)
- Authors: Tshanga, Siphokazi Sisanda
- Date: 2011
- Subjects: Peptide antibiotics , Antibacterial agents -- Therapeutic use -- Testing
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10132 , http://hdl.handle.net/10948/1450 , Peptide antibiotics , Antibacterial agents -- Therapeutic use -- Testing
- Description: Cyclic dipeptides (CDPs) are amino acid-based compounds, some of which possess antibacterial activity. The encapsulation of certain drugs into liposomes has been found to improve their activity in terms of bioavailability and duration of action. Liposomes are small vesicles that are under investigation as drug carriers for the delivery of therapeutic agents. A number of liposome formulations are currently under clinical trial review, whilst some have already been approved for clinical use. The aim of this study was to optimize a liposomal cyclo(Tyr-Pro) formulation and to assess its antibacterial activity against various Gram-positive and Gram-negative bacteria. Response surface methodology (RSM) using the central composite design (CCD) model was used to optimize liposomal formulations of cyclo(Tyr-Pro) for each of the four bacteria, namely Bacillus cereus, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Percent drug encapsulated and bacterial inhibition were investigated with respect to two independent variables, i.e. lipid composition and cholesterol content. Design Expert 8 was used for the purpose of finding the combination of independent variables that would yield an optimal formulation for each bacterium. The model selected by the software failed to adequately correlate the predicted models to the experimental data. The in vitro experiments showed that the antibacterial activity of liposome-encapsulated cyclo(Tyr-Pro) was superior to that of its free counterpart. Binding maximum or Bmax for the encapsulated compound at concentrations as low as 0.412 mg/ml, was significantly higher than that obtained for free cyclo(Tyr-Pro) which was tested at a concentration of 20 mg/ml. Furthermore, encapsulation of cyclo(Tyr-Pro) into a liposome formulation enhanced its potency. This was evident in the lower IC50 values for the liposomal compound when compared to free cyclo(Tyr-Pro).
- Full Text:
- Date Issued: 2011
- Authors: Tshanga, Siphokazi Sisanda
- Date: 2011
- Subjects: Peptide antibiotics , Antibacterial agents -- Therapeutic use -- Testing
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10132 , http://hdl.handle.net/10948/1450 , Peptide antibiotics , Antibacterial agents -- Therapeutic use -- Testing
- Description: Cyclic dipeptides (CDPs) are amino acid-based compounds, some of which possess antibacterial activity. The encapsulation of certain drugs into liposomes has been found to improve their activity in terms of bioavailability and duration of action. Liposomes are small vesicles that are under investigation as drug carriers for the delivery of therapeutic agents. A number of liposome formulations are currently under clinical trial review, whilst some have already been approved for clinical use. The aim of this study was to optimize a liposomal cyclo(Tyr-Pro) formulation and to assess its antibacterial activity against various Gram-positive and Gram-negative bacteria. Response surface methodology (RSM) using the central composite design (CCD) model was used to optimize liposomal formulations of cyclo(Tyr-Pro) for each of the four bacteria, namely Bacillus cereus, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Percent drug encapsulated and bacterial inhibition were investigated with respect to two independent variables, i.e. lipid composition and cholesterol content. Design Expert 8 was used for the purpose of finding the combination of independent variables that would yield an optimal formulation for each bacterium. The model selected by the software failed to adequately correlate the predicted models to the experimental data. The in vitro experiments showed that the antibacterial activity of liposome-encapsulated cyclo(Tyr-Pro) was superior to that of its free counterpart. Binding maximum or Bmax for the encapsulated compound at concentrations as low as 0.412 mg/ml, was significantly higher than that obtained for free cyclo(Tyr-Pro) which was tested at a concentration of 20 mg/ml. Furthermore, encapsulation of cyclo(Tyr-Pro) into a liposome formulation enhanced its potency. This was evident in the lower IC50 values for the liposomal compound when compared to free cyclo(Tyr-Pro).
- Full Text:
- Date Issued: 2011
Antibiotic stewardship: the role of clinical pharmacist
- Authors: Ramkhalawon, Shabeerah
- Date: 2015
- Subjects: Hospital pharmacies -- South Africa Pharmacists -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/10858 , vital:26830
- Description: South Africa has a high prevalence of infectious diseases; the major ones being the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome epidemic, and tuberculosis. South Africa’s burden of resistant bacteria is also increasing. Antibiotic resistance in hospitalised patients leads to an increase in morbidity and mortality, resulting in longer hospital stays, and an increase in hospital costs. In order to counteract the problem of antibiotic resistance in hospitals and other healthcare facilities and preserve the efficacy of currently available antibiotics, there is a need for serious antibiotic management. Antibiotic stewardship initiatives have thus been put in place to guide healthcare professionals on the correct use of antibiotics. Clinical pharmacists can intervene and contribute to antibiotic stewardship owing to comprehensive knowledge of antibiotics, including the properties, uses, safety and efficacy of individual agents. There is a paucity of research to support the role of the clinical pharmacist in antibiotic stewardship in public sector hospitals. The current pharmacist staffing system within public sector hospitals does not adequately support pharmacists, in particular clinical pharmacists, to participate actively in antibiotic stewardship. The primary aim of the study was to evaluate the role of the clinical pharmacist in antibiotic stewardship in a public hospital setting. A secondary aim was to contribute towards more rational inpatient use of antibiotics in the general medical ward. The hypothesis for the study was that clinical pharmacists can make a positive contribution to the correct use of antibiotics in a public hospital setting. The study showed that the introduction of a pharmacist-driven antibiotic stewardship in the ward, using a prospective audit and feedback strategy, had a positive effect on overall appropriateness of antibiotic prescribing (Chi2=7.89; df=3; p=0.04815, Cramer’s V=0.13). However, this finding did not show any reduction in the volume of antibiotic use. Positive patient outcomes were achieved and shown through a reduction in the length of hospital stay (p=0.00487; one-way ANOVA). Although patients were not followed up on discharge to assess re-admission rates, the results are relevant in order to inform the hospital staff about the implementation of antibiotic stewardship at the public hospital setting with the aims of reducing inappropriate antibiotic prescribing and improving patient outcomes. From the results of the study, it can be concluded that the hypothesis was achieved and that the clinical pharmacist did play an integral role in antibiotic prescribing at the public hospital setting. Thus, it can be concluded that the study, though limited in its scope, achieved its aims and objectives, and showed that the clinical pharmacist does play an integral role in the rational use of antibiotics in a public hospital setting.
- Full Text:
- Date Issued: 2015
- Authors: Ramkhalawon, Shabeerah
- Date: 2015
- Subjects: Hospital pharmacies -- South Africa Pharmacists -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/10858 , vital:26830
- Description: South Africa has a high prevalence of infectious diseases; the major ones being the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome epidemic, and tuberculosis. South Africa’s burden of resistant bacteria is also increasing. Antibiotic resistance in hospitalised patients leads to an increase in morbidity and mortality, resulting in longer hospital stays, and an increase in hospital costs. In order to counteract the problem of antibiotic resistance in hospitals and other healthcare facilities and preserve the efficacy of currently available antibiotics, there is a need for serious antibiotic management. Antibiotic stewardship initiatives have thus been put in place to guide healthcare professionals on the correct use of antibiotics. Clinical pharmacists can intervene and contribute to antibiotic stewardship owing to comprehensive knowledge of antibiotics, including the properties, uses, safety and efficacy of individual agents. There is a paucity of research to support the role of the clinical pharmacist in antibiotic stewardship in public sector hospitals. The current pharmacist staffing system within public sector hospitals does not adequately support pharmacists, in particular clinical pharmacists, to participate actively in antibiotic stewardship. The primary aim of the study was to evaluate the role of the clinical pharmacist in antibiotic stewardship in a public hospital setting. A secondary aim was to contribute towards more rational inpatient use of antibiotics in the general medical ward. The hypothesis for the study was that clinical pharmacists can make a positive contribution to the correct use of antibiotics in a public hospital setting. The study showed that the introduction of a pharmacist-driven antibiotic stewardship in the ward, using a prospective audit and feedback strategy, had a positive effect on overall appropriateness of antibiotic prescribing (Chi2=7.89; df=3; p=0.04815, Cramer’s V=0.13). However, this finding did not show any reduction in the volume of antibiotic use. Positive patient outcomes were achieved and shown through a reduction in the length of hospital stay (p=0.00487; one-way ANOVA). Although patients were not followed up on discharge to assess re-admission rates, the results are relevant in order to inform the hospital staff about the implementation of antibiotic stewardship at the public hospital setting with the aims of reducing inappropriate antibiotic prescribing and improving patient outcomes. From the results of the study, it can be concluded that the hypothesis was achieved and that the clinical pharmacist did play an integral role in antibiotic prescribing at the public hospital setting. Thus, it can be concluded that the study, though limited in its scope, achieved its aims and objectives, and showed that the clinical pharmacist does play an integral role in the rational use of antibiotics in a public hospital setting.
- Full Text:
- Date Issued: 2015
Antibiotic use in two hospitals in West Wollega, Ethiopia
- Authors: Banja, Wakweya Dugassa
- Date: 2010
- Subjects: Antibiotics , Bacterial diseases -- Chemotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10141 , http://hdl.handle.net/10948/1263 , Antibiotics , Bacterial diseases -- Chemotherapy
- Description: In the last decades, there has been an escalating consumption of antibiotics with the number of antibiotic prescriptions increasing worldwide. Overuse or inappropriate use of antibiotics has resulted in a major increase in the development of multi-drug resistant pathogens. Antimicrobial resistance is one of the world’s most serious public health problems with great implication in terms of morbidity, mortality, and costs. To date, there has been no formal antibiotic use study conducted in the West Wollega zone of Ethiopia to assess antibiotic utilization. The objective of this study was to determine the pattern of antibiotic use in two hospitals in the West Wollega zone of Ethiopia, namely Gimbie Adventist Hospital and Nedjo Hospitals, using drug utilization metrics and the costs associated. In addition it was to assess the correlation between diagnosed infectious diseases and antibiotic prescriptions. This study was a cross-sectional, retrospective, descriptive review of antibiotic usage in the two hospitals in the year 2007. Prescriptions dispensed in the first month of each quarter of 2007 were reviewed. The number of prescriptions screened, antibiotic courses started, antibiotic days by specific agent and overall, the cost of individual and all antibiotics, the number and type of infectious diseases diagnosed were collected from which core drug use indicators were calculated. The correlation between infectious disease diagnosed and the antibiotic days prescribed were analyzed. A total of 18568 antibiotic and non-antibiotic prescriptions were reviewed retrospectively in the four months of the study period, 47 percent of which contained at least one antibiotic. The average number of antibiotics per prescription was 1.33 and 1.09 whilst the percentage of injectable antibiotics prescribed was 83.2 percent and 3.76 percent to outpatients and inpatients respectively. Antibiotics prescribed from the Essential Drug List (EDL) and List of Drugs for District Hospital (LDDH) were 63.0 percent, 74.8 percent, and 90.8 percent and 76.1 percent for outpatients and inpatients respectively. 98.6 percent of outpatient and 97.0 percent inpatient prescribed antibiotics were actually dispensed. Penicillins and quinolones were the most prescribed antibiotics in both inpatient and outpatient departments constituting 43.46 percent and 24.08 percent respectively. The antibiotic utilization ratio, incidence of outpatient antibiotic use, incidence of inpatient antibiotic use, the number of Defined Daily Doses (DDD)/1000inhabitants/year and DDD/100 Occupied Bed Days (OBD) for the zone was 0.16, 17.25, 23.56, 158.61, and 70 respectively. Antibiotic cost constituted 33.7 percent of all expenditure on drug, cost of antibiotic per patient care day and cost per antibiotic day was 3.84 Ethiopian Birr (ETB) ($0.40) and 6.29 ETB ($0.66) respectively. The correlation between infectious diseases diagnosed and antibiotic prescription shows significant variation. At outpatient departments alone an average number of antibiotic courses started was 2.7 at Gimbie Adventist Hospital and 7.6 for Nedjo Hospital. When overall antibiotic days prescribed and required was compared in both hospitals, there were 2.4 and 5 times more antibiotic days prescribed than were required for Gimbie and Nedjo Hospitals respectively. This suggests that the overuse of antibiotic is worse in the government hospital (Nedjo Hospital) than in the mission hospital (Gimbie Adventist Hospital). This study suggested that there was overuse of antibiotics in the West Wollega hospitals although further investigation is needed to identify its underlying causes and nature. It is recommended that the health personnel, the hospital management, the zonal and regional Health Bureau, the regulatory bodies and Non-Governmental Organizations (NGOs) work hand-in-hand to promote the rational use of antibiotics in this region so that the consequences and financial cost of antimicrobial resistance can be prevented.
- Full Text:
- Date Issued: 2010
- Authors: Banja, Wakweya Dugassa
- Date: 2010
- Subjects: Antibiotics , Bacterial diseases -- Chemotherapy
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10141 , http://hdl.handle.net/10948/1263 , Antibiotics , Bacterial diseases -- Chemotherapy
- Description: In the last decades, there has been an escalating consumption of antibiotics with the number of antibiotic prescriptions increasing worldwide. Overuse or inappropriate use of antibiotics has resulted in a major increase in the development of multi-drug resistant pathogens. Antimicrobial resistance is one of the world’s most serious public health problems with great implication in terms of morbidity, mortality, and costs. To date, there has been no formal antibiotic use study conducted in the West Wollega zone of Ethiopia to assess antibiotic utilization. The objective of this study was to determine the pattern of antibiotic use in two hospitals in the West Wollega zone of Ethiopia, namely Gimbie Adventist Hospital and Nedjo Hospitals, using drug utilization metrics and the costs associated. In addition it was to assess the correlation between diagnosed infectious diseases and antibiotic prescriptions. This study was a cross-sectional, retrospective, descriptive review of antibiotic usage in the two hospitals in the year 2007. Prescriptions dispensed in the first month of each quarter of 2007 were reviewed. The number of prescriptions screened, antibiotic courses started, antibiotic days by specific agent and overall, the cost of individual and all antibiotics, the number and type of infectious diseases diagnosed were collected from which core drug use indicators were calculated. The correlation between infectious disease diagnosed and the antibiotic days prescribed were analyzed. A total of 18568 antibiotic and non-antibiotic prescriptions were reviewed retrospectively in the four months of the study period, 47 percent of which contained at least one antibiotic. The average number of antibiotics per prescription was 1.33 and 1.09 whilst the percentage of injectable antibiotics prescribed was 83.2 percent and 3.76 percent to outpatients and inpatients respectively. Antibiotics prescribed from the Essential Drug List (EDL) and List of Drugs for District Hospital (LDDH) were 63.0 percent, 74.8 percent, and 90.8 percent and 76.1 percent for outpatients and inpatients respectively. 98.6 percent of outpatient and 97.0 percent inpatient prescribed antibiotics were actually dispensed. Penicillins and quinolones were the most prescribed antibiotics in both inpatient and outpatient departments constituting 43.46 percent and 24.08 percent respectively. The antibiotic utilization ratio, incidence of outpatient antibiotic use, incidence of inpatient antibiotic use, the number of Defined Daily Doses (DDD)/1000inhabitants/year and DDD/100 Occupied Bed Days (OBD) for the zone was 0.16, 17.25, 23.56, 158.61, and 70 respectively. Antibiotic cost constituted 33.7 percent of all expenditure on drug, cost of antibiotic per patient care day and cost per antibiotic day was 3.84 Ethiopian Birr (ETB) ($0.40) and 6.29 ETB ($0.66) respectively. The correlation between infectious diseases diagnosed and antibiotic prescription shows significant variation. At outpatient departments alone an average number of antibiotic courses started was 2.7 at Gimbie Adventist Hospital and 7.6 for Nedjo Hospital. When overall antibiotic days prescribed and required was compared in both hospitals, there were 2.4 and 5 times more antibiotic days prescribed than were required for Gimbie and Nedjo Hospitals respectively. This suggests that the overuse of antibiotic is worse in the government hospital (Nedjo Hospital) than in the mission hospital (Gimbie Adventist Hospital). This study suggested that there was overuse of antibiotics in the West Wollega hospitals although further investigation is needed to identify its underlying causes and nature. It is recommended that the health personnel, the hospital management, the zonal and regional Health Bureau, the regulatory bodies and Non-Governmental Organizations (NGOs) work hand-in-hand to promote the rational use of antibiotics in this region so that the consequences and financial cost of antimicrobial resistance can be prevented.
- Full Text:
- Date Issued: 2010
Antimicrobial activities of three medicinal plants against selected diarrheagenic pathogens
- Authors: Nkosi, Themba Johan
- Date: 2013
- Subjects: Anti-infective agents , Drug resistance in microorganisms , Materia medica, Vegetable
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10126 , http://hdl.handle.net/10948/d1020759
- Description: Diarrhea is a global concern that the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), have confirmed to be the second major cause of death in children under the age of five. Major bacterial pathogens that cause diarrhea include Escherichia coli, Salmonella species, Shigella species and Staphylococcus aureus. Antibiotic therapy is recommended depending on the severity and presentation of the disease; however, the appearance of antibiotic-resistant bacteria is an emerging global threat to the ability to treat these bacterial infections. This situation could be overcome by the discovery of new natural antibiotics. Plants have been a source of medicine for centuries and have been used to treat diseases including diarrhea. This makes plants a natural potential target to study for their antibiotic properties. The objective of this study was to determine the antibiotic properties of medicinal plants against known pathogens that cause bacterial diarrhea. Three medicinal plants, Cassia abbreviata, Kigelia africana, and Geranium incanum were investigated for their antimicrobial properties against these strains of microorganisms: American Type Culture Collection (ATTC) and Clinical Strains (CS). The plant materials were ground into powder, which was then dissolved in methanol, acetone and distilled water to extract the active compounds. The plant extracts were then used to (i) determine their antibiotic activity, (ii) determine the minimum inhibitory concentration (MICs), (iii) analyze the thin layer chromatography (TLC) fingerprints, and (iv) analyze the autobiography assay. The results obtained in this study met the aim and objectives of this study. The antimicrobial activities of the selected plants were obtained as discussed in Chapter 2 and 3. These results indicated that the traditional plants could be used as antimicrobials. In the screening assays, the test microorganisms were inhibited by the plant extracts, when they were subjected to plant extracts. This was performed on Mueller Hinton agar as sensitivity testing, which revealed clear zones of inhibition. The MIC values for each plant extract were established which ranged from 0.101 to 13.3 mg/dl. The TLC analysis revealed the spots which contained the active compounds which inhibited the bacterial growth. A bioautography assay was performed on the TLC plates, which exposed the exact spots containing the active compound inhibiting the bacteria. These results are clearly consistent with what former scientists have observed. Detailed explanations on the results are in Chapter 3 and 4 of this paper. It is important to note that all the procedures performed in this study were in vitro assays. Some effective in vitro assay activity may not always result in the same effective in vivo activity, because some active compounds may be metabolized and degraded into inactive metabolites. For this reason, the in vitro results obtained in this study, may not reflect the true effectiveness of the compounds in in vivo trials. It is therefore advised that future scientists should take a step further in analyzing the plant extracts through in vivo assays. Further testing and study on these plants at an advanced molecular level will be beneficial in the medical fields in the search for new antibiotics to treat infectious diseases. Purification and further analysis of their products can be helpful in the production of pure natural medicines. This will discover the active ingredients and compounds responsible for inhibition of the microorganisms. This will make the compounds potential candidates for a scientific validation and analysis for future scientists to bring a new dawn in the fight against infectious diseases.
- Full Text:
- Date Issued: 2013
- Authors: Nkosi, Themba Johan
- Date: 2013
- Subjects: Anti-infective agents , Drug resistance in microorganisms , Materia medica, Vegetable
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10126 , http://hdl.handle.net/10948/d1020759
- Description: Diarrhea is a global concern that the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), have confirmed to be the second major cause of death in children under the age of five. Major bacterial pathogens that cause diarrhea include Escherichia coli, Salmonella species, Shigella species and Staphylococcus aureus. Antibiotic therapy is recommended depending on the severity and presentation of the disease; however, the appearance of antibiotic-resistant bacteria is an emerging global threat to the ability to treat these bacterial infections. This situation could be overcome by the discovery of new natural antibiotics. Plants have been a source of medicine for centuries and have been used to treat diseases including diarrhea. This makes plants a natural potential target to study for their antibiotic properties. The objective of this study was to determine the antibiotic properties of medicinal plants against known pathogens that cause bacterial diarrhea. Three medicinal plants, Cassia abbreviata, Kigelia africana, and Geranium incanum were investigated for their antimicrobial properties against these strains of microorganisms: American Type Culture Collection (ATTC) and Clinical Strains (CS). The plant materials were ground into powder, which was then dissolved in methanol, acetone and distilled water to extract the active compounds. The plant extracts were then used to (i) determine their antibiotic activity, (ii) determine the minimum inhibitory concentration (MICs), (iii) analyze the thin layer chromatography (TLC) fingerprints, and (iv) analyze the autobiography assay. The results obtained in this study met the aim and objectives of this study. The antimicrobial activities of the selected plants were obtained as discussed in Chapter 2 and 3. These results indicated that the traditional plants could be used as antimicrobials. In the screening assays, the test microorganisms were inhibited by the plant extracts, when they were subjected to plant extracts. This was performed on Mueller Hinton agar as sensitivity testing, which revealed clear zones of inhibition. The MIC values for each plant extract were established which ranged from 0.101 to 13.3 mg/dl. The TLC analysis revealed the spots which contained the active compounds which inhibited the bacterial growth. A bioautography assay was performed on the TLC plates, which exposed the exact spots containing the active compound inhibiting the bacteria. These results are clearly consistent with what former scientists have observed. Detailed explanations on the results are in Chapter 3 and 4 of this paper. It is important to note that all the procedures performed in this study were in vitro assays. Some effective in vitro assay activity may not always result in the same effective in vivo activity, because some active compounds may be metabolized and degraded into inactive metabolites. For this reason, the in vitro results obtained in this study, may not reflect the true effectiveness of the compounds in in vivo trials. It is therefore advised that future scientists should take a step further in analyzing the plant extracts through in vivo assays. Further testing and study on these plants at an advanced molecular level will be beneficial in the medical fields in the search for new antibiotics to treat infectious diseases. Purification and further analysis of their products can be helpful in the production of pure natural medicines. This will discover the active ingredients and compounds responsible for inhibition of the microorganisms. This will make the compounds potential candidates for a scientific validation and analysis for future scientists to bring a new dawn in the fight against infectious diseases.
- Full Text:
- Date Issued: 2013
Antimicrobial activity of selected Eastern Cape medical plants
- Authors: Mohlakoana, Keneuoe
- Date: 2010
- Subjects: Materia medica, Vegetable -- South Africa , Drug resistance in microorganisms -- South Africa , Anti-infective agents -- South Africa , Antibiotics
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10120 , http://hdl.handle.net/10948/1199 , Materia medica, Vegetable -- South Africa , Drug resistance in microorganisms -- South Africa , Anti-infective agents -- South Africa , Antibiotics
- Description: Bacterial resistance to antibiotics has been a great problem for many years. The degree of resistance and the speed with which resistance develops varies with different organisms and different drugs. Enzymes called β-lactamases are produced by bacteria and are one mechanism in which bacteria develop antimicrobial resistance. Gram-negative bacteria producing enzymes called ESBLs because of their wide substrate range are of a particular concern in nosocomial infections. In many countries people still use traditional medicine derived from plants as an alternative to the Western medicine due to increased cost of Western medicine and microbial resistance of antibiotic treatments. Biologically active compounds isolated from plants species are used in herbal medicine. Because of the high prevalence of the ESBLs and their increasing resistance to the antibiotics, this research study was done to test the antimicrobial activities of selected medicinal plants of the Eastern Cape; G. incanum, D. angustifolia and E. autumnalis which were traditionally used to treat various infections. The in vitro antimicrobial activity of three different extracts (acetone, methanol & distilled water) and the traditional preparations of the three plants were tested against the selected strains of ESBL-producing bacteria, non β-lactamase producers and the different fungal species. The extracts were screened against 26 Gram-positive bacterial strains, 53 Gram-negative bacterial strains and 15 fungal strains. The Gram-positive bacteria included strains from S. aureus, B. cereus and E. faecalis. The Gram-negative bacteria included strains from E. ii coli, E. cloacae, K. pneumoniae, P. aeruginosa and Acinetobacter spp. The fungal strains included 9 strains of Candida albicans and a single strain of each of the following opportunistic fungi, Mucor sp, Geotrichium sp, Penicillium sp, Fusarium sp and Rhizopus sp. The agar dilution assay was used for the antimicrobial screening of the plants extracts and for the determination of the MICs. The Ames test was performed for the determination of probable carcinogenicity of the extracts of G. incanum and D. angustifolia. The distilled water extracts followed by acetone extracts of the plants revealed the highest antimicrobial activity against the different microbial strains. The extracts of G. incanum followed by the extracts of D. angustifolia inhibited the highest number of microbial strains. The extracts of E. autumnalis did not show any antimicrobial activity against all the pathogens in this study. More of the Gram-positive bacteria were inhibited by the plant extracts. The lowest MIC was obtained with Gram-positive bacteria. The bacterial strains of E. faecalis and P. aeruginosa were not inhibited by any of the plants extracts in the agar dilution assay yet Acinetobacter species which are MDR were inhibited by the distilled water and methanol extracts of G. incanum. A single strain of Mucor sp was the only spore forming fungi that was inhibited by the distilled water extracts of G. incanum. None of the plants extracts showed any mutagenic effects on the TA100 S. typhimurium strains incorporated on the Ames test. Apart from revealing of new antimicrobial agents that may be used against resistant organisms, the proper use of antimicrobial agents should be recommended. The study has highlighted a need for further investigations on the properties of the medicinal plants used in this study.
- Full Text:
- Date Issued: 2010
- Authors: Mohlakoana, Keneuoe
- Date: 2010
- Subjects: Materia medica, Vegetable -- South Africa , Drug resistance in microorganisms -- South Africa , Anti-infective agents -- South Africa , Antibiotics
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:10120 , http://hdl.handle.net/10948/1199 , Materia medica, Vegetable -- South Africa , Drug resistance in microorganisms -- South Africa , Anti-infective agents -- South Africa , Antibiotics
- Description: Bacterial resistance to antibiotics has been a great problem for many years. The degree of resistance and the speed with which resistance develops varies with different organisms and different drugs. Enzymes called β-lactamases are produced by bacteria and are one mechanism in which bacteria develop antimicrobial resistance. Gram-negative bacteria producing enzymes called ESBLs because of their wide substrate range are of a particular concern in nosocomial infections. In many countries people still use traditional medicine derived from plants as an alternative to the Western medicine due to increased cost of Western medicine and microbial resistance of antibiotic treatments. Biologically active compounds isolated from plants species are used in herbal medicine. Because of the high prevalence of the ESBLs and their increasing resistance to the antibiotics, this research study was done to test the antimicrobial activities of selected medicinal plants of the Eastern Cape; G. incanum, D. angustifolia and E. autumnalis which were traditionally used to treat various infections. The in vitro antimicrobial activity of three different extracts (acetone, methanol & distilled water) and the traditional preparations of the three plants were tested against the selected strains of ESBL-producing bacteria, non β-lactamase producers and the different fungal species. The extracts were screened against 26 Gram-positive bacterial strains, 53 Gram-negative bacterial strains and 15 fungal strains. The Gram-positive bacteria included strains from S. aureus, B. cereus and E. faecalis. The Gram-negative bacteria included strains from E. ii coli, E. cloacae, K. pneumoniae, P. aeruginosa and Acinetobacter spp. The fungal strains included 9 strains of Candida albicans and a single strain of each of the following opportunistic fungi, Mucor sp, Geotrichium sp, Penicillium sp, Fusarium sp and Rhizopus sp. The agar dilution assay was used for the antimicrobial screening of the plants extracts and for the determination of the MICs. The Ames test was performed for the determination of probable carcinogenicity of the extracts of G. incanum and D. angustifolia. The distilled water extracts followed by acetone extracts of the plants revealed the highest antimicrobial activity against the different microbial strains. The extracts of G. incanum followed by the extracts of D. angustifolia inhibited the highest number of microbial strains. The extracts of E. autumnalis did not show any antimicrobial activity against all the pathogens in this study. More of the Gram-positive bacteria were inhibited by the plant extracts. The lowest MIC was obtained with Gram-positive bacteria. The bacterial strains of E. faecalis and P. aeruginosa were not inhibited by any of the plants extracts in the agar dilution assay yet Acinetobacter species which are MDR were inhibited by the distilled water and methanol extracts of G. incanum. A single strain of Mucor sp was the only spore forming fungi that was inhibited by the distilled water extracts of G. incanum. None of the plants extracts showed any mutagenic effects on the TA100 S. typhimurium strains incorporated on the Ames test. Apart from revealing of new antimicrobial agents that may be used against resistant organisms, the proper use of antimicrobial agents should be recommended. The study has highlighted a need for further investigations on the properties of the medicinal plants used in this study.
- Full Text:
- Date Issued: 2010
Antimicrobial activity of selected plants and their combined preparations against pathogens causing respiratory infections
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
- Authors: Onyebuchi, Ukwuoma Collins
- Date: 2017
- Subjects: Anti-infective agents , Respiratory infections -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/21197 , vital:29455
- Description: Bacterial infection of the respiratory system is one of the leading causes of death in the world’s population, killing over four million people annually. Treatment of respiratory infections is usually by antibiotics administration. The emergence of multi-drug-resistant pathogens has led to the search for more effective therapeutic agents especially from medicinal plants, as compounds from plants have been shown to possess some therapeutic potential. The aim of this study is to determine the antimicrobial activity of three plants, Tetradenia riparia, Leonotis leonurus and Salvia africana-lutea and the activity of their various combined preparations against 27 pathogens usually associated with respiratory ailments. Various solvents were used for extraction of the dried powdered plant materials. The agar disc diffusion antimicrobial assay and the micro-dilution assay methods were used to determine the inhibitory activity and the minimum inhibitory concentration of the plant extracts. The nature of phytochemicals present in the extracts was determined by thin layer chromatography. The results obtained in this study, showed that ethanol produced the highest average extract yield in both the individual and combined plant preparations. A two-way analysis of variance for the disc diffusion assay showed no significant difference in the inhibition zones (Appendix 1 and 2). MIC of 0.8 mg/ml was obtained with S. africana-lutea against S. pneumoniae ATCC 49619 and B. cereus ATCC 10976 strains, indicating a strong antibacterial activity. Synergistic interaction (FIC index ranging from 0.20 – 0.50) and a strong antimicrobial activity (MIC values ranging from 0.4 – 0.8 mg/ml), was obtained with the acetone extract of the 1:1 combination of L. leonurus with S. africana-lutea. The XEA and CEF solvent systems eluted the most number of compound spots and produced the best separations. The results obtained in this study validate the traditional use of these plants and their combinations for the treatment of respiratory ailments.
- Full Text:
- Date Issued: 2017
Application of a quality by design approach to optimise an existing product
- Authors: Maxwell, Taryn Lee
- Date: 2018
- Subjects: Pharmaceutical chemistry , Drugs -- Design Pharmaceutical technology
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/32752 , vital:32341
- Description: Quality by design is a science and risk based approach whereby quality is built into the product or process during the pharmaceutical development. although quality by design is encouraged for pharmaceutical development. it is possible to apply quality by design to optimize an existing product as part of a continual improvement strategy. the purpose of this study is to determine which factors should be considered to justify the application of quality by design to optimize an existing product.
- Full Text: false
- Date Issued: 2018
- Authors: Maxwell, Taryn Lee
- Date: 2018
- Subjects: Pharmaceutical chemistry , Drugs -- Design Pharmaceutical technology
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/32752 , vital:32341
- Description: Quality by design is a science and risk based approach whereby quality is built into the product or process during the pharmaceutical development. although quality by design is encouraged for pharmaceutical development. it is possible to apply quality by design to optimize an existing product as part of a continual improvement strategy. the purpose of this study is to determine which factors should be considered to justify the application of quality by design to optimize an existing product.
- Full Text: false
- Date Issued: 2018
Application of health belief model in developing contextual guidelines for adherence to antiretroviral treatment among adolescents and youths in Buffalo City Metropolitan Municipality District, East London, South Africa
- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
- Full Text:
- Date Issued: 2018
- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
- Full Text:
- Date Issued: 2018
Approach to National Health Workforce Planning for health service delivery in South Africa
- Authors: Mahlathi, Malixole Percival
- Date: 2009-12
- Subjects: Health planning , Rural health services , Labor turnover
- Language: English
- Type: text
- Identifier: http://hdl.handle.net/10353/25216 , vital:64058
- Description: Although South Africa educates and trains many health professionals of various categories, it continues to experience relative and critical shortages of these professionals especially at its rural health facilities. It boasts more than 15 Faculties of Health Sciences which train a variety of health professionals. In addition to training for its own purposes, it also offers training for several countries in the Southern African Development Community. The burden of disease is considered to be high and increasing, complicated by the HIV and AIDS epidemic. In the light of these challenges it is necessary that South Africa engages in careful health workforce planning as a long term approach to solve shortage of health professionals and improving the delivery of health services. This study examines the health workforce planning approaches by the various Provincial Departments of Health and the student planning approaches by the Faculties of Health Sciences of the Higher Education Institutions that train health professionals. , Thesis (PhD) -- Faculty of Health Sciences, 2009
- Full Text:
- Date Issued: 2009-12
- Authors: Mahlathi, Malixole Percival
- Date: 2009-12
- Subjects: Health planning , Rural health services , Labor turnover
- Language: English
- Type: text
- Identifier: http://hdl.handle.net/10353/25216 , vital:64058
- Description: Although South Africa educates and trains many health professionals of various categories, it continues to experience relative and critical shortages of these professionals especially at its rural health facilities. It boasts more than 15 Faculties of Health Sciences which train a variety of health professionals. In addition to training for its own purposes, it also offers training for several countries in the Southern African Development Community. The burden of disease is considered to be high and increasing, complicated by the HIV and AIDS epidemic. In the light of these challenges it is necessary that South Africa engages in careful health workforce planning as a long term approach to solve shortage of health professionals and improving the delivery of health services. This study examines the health workforce planning approaches by the various Provincial Departments of Health and the student planning approaches by the Faculties of Health Sciences of the Higher Education Institutions that train health professionals. , Thesis (PhD) -- Faculty of Health Sciences, 2009
- Full Text:
- Date Issued: 2009-12
Articulating the nature of clinical nurse specialist practice
- Authors: Bell, Janet Deanne
- Date: 2015
- Subjects: Nurse practitioners , Intensive care nursing
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10057 , http://hdl.handle.net/10948/d1018623
- Description: Critical care nursing is a clinical specialist nursing practice discipline. The critical care nurse provides a constant presence in the care of a critically ill patient. She/he creates a thread of continuity in care through the myriad of other health care professionals and activities that form part of a patient’s stay in the critical care environment (World Federation of Critical Care Nurses [WFCCN], 2007). During conversations with people who have had intimate experience of the critical care environment, they have offered anecdotes that describe their interaction with critical care nurses who they perceive to be different from and better than other critical care nurses they encountered. Despite having met common professional requirements to be registered as a clinical specialist nurse, these distinctive, unique abilities that seem to be influential in meeting the complex needs and expectations of critically ill patients, their significant others as well as nursing and medical colleagues, are not displayed by all critical care nurses. While students of accredited postgraduate nursing programmes are required to advance their nursing knowledge and skill competence, many students do not seem to develop other, perhaps more tacit, qualities that utilisers characterise in their anecdotes of ‘different and better’ nursing practice. The overarching research question guiding this study was how can ‘different and better’ critical care nursing practice as recognised by a utiliser be explained? The purpose of this study was to develop an understanding of the qualities that those people who use critical care nursing practice recognise as ‘different and better’ to the norm of nursing practice they encounter in this discipline. The participant sample included patients’ significant others, nursing colleagues and medical colleagues of critical care nurses, collectively identified as utilisers. The stated aim of this work was to construct a grounded theory to elucidate an understanding of the qualities that a utiliser of critical care nursing recognises as ‘different and better’ critical care nursing practice in order to enhance the teaching and learning encounters between nurse educators and postgraduate students in learning programmes aiming to develop clinical specialist nurses. The method processes of grounded theory are designed to reveal and confirm concepts from within the data as well as the connections between these concepts, supporting the researcher in crafting a substantive theory that is definitively grounded in the participants’ views and stories (Streubert & Carpenter, 2011: 123, 128-129). Two data collection tools were employed in this study, namely in-depth unstructured individual interviews and naïve sketch. Constant comparative analysis, memo-writing, theoretical sampling, theoretical sensitivity and theoretical saturation as fundamental methods of data generation in grounded theory were applied. The study unfolded through three broad parts, namely: Forming & shaping this grounded theory through exploration and co-creation; Assimilating & situating this grounded theory through understanding and enfolding; Reflecting on this grounded theory through contemplating and reconnecting. The outcome of the first part of the study was my initial proposition of a grounded theory co-created in the interactions between the participants and myself. This was then challenged, developed and assimilated through a focussed literature review through the second part of the study. Through these two parts of this study, an inductively derived explanation was formed and shaped to produce an assimilated and situated substantive grounded theory named Being at Ease. This grounded theory articulates how ‘better and different’ nursing is recognised from the point of view of those who use the nursing ability of critical care nurses through the core concern ‘being at ease’ and its four categories ‘knowing self’, ‘skilled being’, connecting with intention’ and’ anchoring’. The final part of this study unfolded in my reflections on what this grounded theory had revealed about nurses and elements of nursing practice that are important to a utiliser in recognising ‘different and better’ critical care nursing. I suggest that as nurses we need to develop a language that enables us to reveal with clarity these intangible and tacit elements recognised within the being and doing of ‘different and better’ nursing. I reflected on the pivotal space of influence a teacher has with a student, and on how the elements essential in being and doing ‘different and better’ nursing need to be evident in her/his own ways of being a teacher of nursing. Teaching and learning encounters may be enhanced through drawing what this theory has shown as necessary elements that shape ‘different and better’ nurses through the moments of influence a teacher has in each encounter with a student.
- Full Text:
- Date Issued: 2015
- Authors: Bell, Janet Deanne
- Date: 2015
- Subjects: Nurse practitioners , Intensive care nursing
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10057 , http://hdl.handle.net/10948/d1018623
- Description: Critical care nursing is a clinical specialist nursing practice discipline. The critical care nurse provides a constant presence in the care of a critically ill patient. She/he creates a thread of continuity in care through the myriad of other health care professionals and activities that form part of a patient’s stay in the critical care environment (World Federation of Critical Care Nurses [WFCCN], 2007). During conversations with people who have had intimate experience of the critical care environment, they have offered anecdotes that describe their interaction with critical care nurses who they perceive to be different from and better than other critical care nurses they encountered. Despite having met common professional requirements to be registered as a clinical specialist nurse, these distinctive, unique abilities that seem to be influential in meeting the complex needs and expectations of critically ill patients, their significant others as well as nursing and medical colleagues, are not displayed by all critical care nurses. While students of accredited postgraduate nursing programmes are required to advance their nursing knowledge and skill competence, many students do not seem to develop other, perhaps more tacit, qualities that utilisers characterise in their anecdotes of ‘different and better’ nursing practice. The overarching research question guiding this study was how can ‘different and better’ critical care nursing practice as recognised by a utiliser be explained? The purpose of this study was to develop an understanding of the qualities that those people who use critical care nursing practice recognise as ‘different and better’ to the norm of nursing practice they encounter in this discipline. The participant sample included patients’ significant others, nursing colleagues and medical colleagues of critical care nurses, collectively identified as utilisers. The stated aim of this work was to construct a grounded theory to elucidate an understanding of the qualities that a utiliser of critical care nursing recognises as ‘different and better’ critical care nursing practice in order to enhance the teaching and learning encounters between nurse educators and postgraduate students in learning programmes aiming to develop clinical specialist nurses. The method processes of grounded theory are designed to reveal and confirm concepts from within the data as well as the connections between these concepts, supporting the researcher in crafting a substantive theory that is definitively grounded in the participants’ views and stories (Streubert & Carpenter, 2011: 123, 128-129). Two data collection tools were employed in this study, namely in-depth unstructured individual interviews and naïve sketch. Constant comparative analysis, memo-writing, theoretical sampling, theoretical sensitivity and theoretical saturation as fundamental methods of data generation in grounded theory were applied. The study unfolded through three broad parts, namely: Forming & shaping this grounded theory through exploration and co-creation; Assimilating & situating this grounded theory through understanding and enfolding; Reflecting on this grounded theory through contemplating and reconnecting. The outcome of the first part of the study was my initial proposition of a grounded theory co-created in the interactions between the participants and myself. This was then challenged, developed and assimilated through a focussed literature review through the second part of the study. Through these two parts of this study, an inductively derived explanation was formed and shaped to produce an assimilated and situated substantive grounded theory named Being at Ease. This grounded theory articulates how ‘better and different’ nursing is recognised from the point of view of those who use the nursing ability of critical care nurses through the core concern ‘being at ease’ and its four categories ‘knowing self’, ‘skilled being’, connecting with intention’ and’ anchoring’. The final part of this study unfolded in my reflections on what this grounded theory had revealed about nurses and elements of nursing practice that are important to a utiliser in recognising ‘different and better’ critical care nursing. I suggest that as nurses we need to develop a language that enables us to reveal with clarity these intangible and tacit elements recognised within the being and doing of ‘different and better’ nursing. I reflected on the pivotal space of influence a teacher has with a student, and on how the elements essential in being and doing ‘different and better’ nursing need to be evident in her/his own ways of being a teacher of nursing. Teaching and learning encounters may be enhanced through drawing what this theory has shown as necessary elements that shape ‘different and better’ nurses through the moments of influence a teacher has in each encounter with a student.
- Full Text:
- Date Issued: 2015
Assessing communication challenges between clerks and deaf patients at Nelson Mandela Academic Hospital in Mthatha
- Authors: Stemela, Unati
- Date: 2011
- Subjects: Clerks and deaf patients -- Communication -- Hospital
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18417 , http://hdl.handle.net/11260/d1006597
- Description: A study on assessing communication challenges between clerks and deaf patients at Nelson Mandela Academic Hospital was conducted in 2010. The aim was to assess the existence of communication challenges, possible reasons and solutions to these. The literature reviewed identified a gap in the knowledge of communication between staff and deaf patients. A health systems’ study was conducted using a descriptive, cross sectional survey. The study population was made up of 33 clerks who worked at the registration and records area and deaf patients who stayed at Efata and received health services from the hospital. All clerks were interviewed and a random sample of 106 deaf patients was estimated using Epidat statistical software. Self administered questionnaires were used for data collection. Results confirmed the existence of communication challenges between the two groups. A majority of clerks were not trained in Sign Language. They used a combination of methods to communicate with deaf patients, and few clerks could use Sign Language. The patients also used a combination of methods due to the frustration of not having a common method of communication with clerks. The findings clearly showed that there are communication challenges between the two groups and Sign Language needed to be introduced to clerks in order to accommodate deaf patients. Further research may be done on all healthcare providers and to all deaf patients in the region served by Nelson Mandela Academic Hospital, and this could have a positive impact on the quality of service offered by the hospital to the deaf community.
- Full Text:
- Date Issued: 2011
- Authors: Stemela, Unati
- Date: 2011
- Subjects: Clerks and deaf patients -- Communication -- Hospital
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18417 , http://hdl.handle.net/11260/d1006597
- Description: A study on assessing communication challenges between clerks and deaf patients at Nelson Mandela Academic Hospital was conducted in 2010. The aim was to assess the existence of communication challenges, possible reasons and solutions to these. The literature reviewed identified a gap in the knowledge of communication between staff and deaf patients. A health systems’ study was conducted using a descriptive, cross sectional survey. The study population was made up of 33 clerks who worked at the registration and records area and deaf patients who stayed at Efata and received health services from the hospital. All clerks were interviewed and a random sample of 106 deaf patients was estimated using Epidat statistical software. Self administered questionnaires were used for data collection. Results confirmed the existence of communication challenges between the two groups. A majority of clerks were not trained in Sign Language. They used a combination of methods to communicate with deaf patients, and few clerks could use Sign Language. The patients also used a combination of methods due to the frustration of not having a common method of communication with clerks. The findings clearly showed that there are communication challenges between the two groups and Sign Language needed to be introduced to clerks in order to accommodate deaf patients. Further research may be done on all healthcare providers and to all deaf patients in the region served by Nelson Mandela Academic Hospital, and this could have a positive impact on the quality of service offered by the hospital to the deaf community.
- Full Text:
- Date Issued: 2011
Assessing Diabetes distress amongst type 2 Diabetic patients at the Mhlontlo sub-district healthcare clinics in the OR Tambo health District
- Authors: Mboniso, Veronica
- Date: 2022-12
- Subjects: Diabetes , Medical care , Primary health care -- OR Tambo Health District
- Language: English
- Type: Master's theses , Thesis
- Identifier: http://hdl.handle.net/10948/60111 , vital:63096
- Description: Diabetes mellitus is a chronic endocrine condition that requires lifestyle changes and a commitment to its management to ensure patient well-being, although this can be challenging for various reasons. In addition, diabetes is a behavioural and emotionally demanding condition that could affect the psychosocial well-being of a patient. Diabetes distress is quite common in people living with diabetes, as they lose hope easily, especially when their diabetes is uncontrolled. The research study identified and described factors contributing to diabetes distress amongst type 2 diabetic patients at Mhlontlo Sub-District healthcare clinics in the OR Tambo Health District. Probability sampling was used to select patients who were 18 years and older after approval from Nelson Mandela University (NMU) and relevant authorisation was obtained. The study was conducted between August and October 2021, using a quantitative, exploratory and descriptive research design. The data were collected using a self-administered questionnaire, which had been adapted from the Diabetes Distress Scale-17 (DDS-17) created by Polonsky et al. (2005). A total of 136 diabetic patients completed the questionnaire, which comprised three sections: demographic information (Section A); the DDS-17 (Section B); and contributing factors to diabetes distress in diabetic patients at Mhlontlo Sub-District healthcare clinics (Section C). The researcher conducted a pilot study in one of the clinics to check the feasibility of the questionnaire. After the data were collected, it was statistically analysed with the assistance of a statistician to generate descriptive and inferential statistics. The analysed data revealed that most of the diabetic patients indicated that they found travelling far to fetch medication and standing in long queues at the clinic distressing. Therefore, they wanted the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme to be rolled out to bring medication to them. The results also revealed that the patients' diabetes distress was exacerbated by them having to travel to clinics in search of medication when their usual clinic had no adequate v stocks of medication. Another factor contributing to the patients’ diabetes distress was the lack of a doctor on site. The patients indicated that doctors should be available at the clinics, even periodically, to address problems that cannot be solved by nurses. The absence of haemoglucotest (HGT machines at clinics was another contributing factor to diabetes distress. Most of the patients in the study felt that they would manage their diabetes better if the government supplied these machines. The results informed various recommendations that might help the management of OR Tambo Health District to make changes and thus minimise the diabetes distress reported by its patients. However, the study had limitations, although it observed the principles of reliability and validity. Moreover, ethical considerations were guided by the Belmont Report, and the study adhered to the principles of informed consent, respect for persons, anonymity, confidentiality, beneficence, nonmaleficence and distributive justice. , Thesis (MNur) -- Faculty of Health Sciences, School of Lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Mboniso, Veronica
- Date: 2022-12
- Subjects: Diabetes , Medical care , Primary health care -- OR Tambo Health District
- Language: English
- Type: Master's theses , Thesis
- Identifier: http://hdl.handle.net/10948/60111 , vital:63096
- Description: Diabetes mellitus is a chronic endocrine condition that requires lifestyle changes and a commitment to its management to ensure patient well-being, although this can be challenging for various reasons. In addition, diabetes is a behavioural and emotionally demanding condition that could affect the psychosocial well-being of a patient. Diabetes distress is quite common in people living with diabetes, as they lose hope easily, especially when their diabetes is uncontrolled. The research study identified and described factors contributing to diabetes distress amongst type 2 diabetic patients at Mhlontlo Sub-District healthcare clinics in the OR Tambo Health District. Probability sampling was used to select patients who were 18 years and older after approval from Nelson Mandela University (NMU) and relevant authorisation was obtained. The study was conducted between August and October 2021, using a quantitative, exploratory and descriptive research design. The data were collected using a self-administered questionnaire, which had been adapted from the Diabetes Distress Scale-17 (DDS-17) created by Polonsky et al. (2005). A total of 136 diabetic patients completed the questionnaire, which comprised three sections: demographic information (Section A); the DDS-17 (Section B); and contributing factors to diabetes distress in diabetic patients at Mhlontlo Sub-District healthcare clinics (Section C). The researcher conducted a pilot study in one of the clinics to check the feasibility of the questionnaire. After the data were collected, it was statistically analysed with the assistance of a statistician to generate descriptive and inferential statistics. The analysed data revealed that most of the diabetic patients indicated that they found travelling far to fetch medication and standing in long queues at the clinic distressing. Therefore, they wanted the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme to be rolled out to bring medication to them. The results also revealed that the patients' diabetes distress was exacerbated by them having to travel to clinics in search of medication when their usual clinic had no adequate v stocks of medication. Another factor contributing to the patients’ diabetes distress was the lack of a doctor on site. The patients indicated that doctors should be available at the clinics, even periodically, to address problems that cannot be solved by nurses. The absence of haemoglucotest (HGT machines at clinics was another contributing factor to diabetes distress. Most of the patients in the study felt that they would manage their diabetes better if the government supplied these machines. The results informed various recommendations that might help the management of OR Tambo Health District to make changes and thus minimise the diabetes distress reported by its patients. However, the study had limitations, although it observed the principles of reliability and validity. Moreover, ethical considerations were guided by the Belmont Report, and the study adhered to the principles of informed consent, respect for persons, anonymity, confidentiality, beneficence, nonmaleficence and distributive justice. , Thesis (MNur) -- Faculty of Health Sciences, School of Lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Assessing South African Medical Interns’ Experience and Confidence in Managing Obstetric Emergencies
- Authors: Miller, Andrew
- Date: 2021-02
- Subjects: Obstetrical emergencies
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6882 , vital:52352
- Description: Background: Medical doctors in South Africa are required to complete a two-year internship at training hospitals, including a four-month rotation in obstetrics and gynaecology. Following this, doctors are allocated to community service posts; many of which are at district and primary level facilities where supervision is limited. The latest triennial Saving Mothers Report identified district hospitals as the second leading site for maternal deaths of all causes. District hospital were also the leading site for maternal deaths secondary to obstetric haemorrhage and the most likely site for the lack of a skilled doctor to be identified as a factor in deaths associated with caesarean delivery. Methods: This cross-sectional descriptive study aimed to describe the self-perceived readiness of medical interns completing their training to independently manage obstetric emergencies, based on the ESMOE modules in the HPCSA internship logbook. The research assessed medical interns in the last three months of their training, using a self-administered online questionnaire, with data collection between October and December 2019. Cluster sampling of interns at training facilities throughout the country resulted in a total of 182 respondents from 17 hospitals in seven provinces in the country, with an overall response rate of 34.1%. Results: Most interns had experience with, and confidence in, the management of miscarriage and hypertension in pregnancy. However, gaps in labour ward management, pregnancy related sepsis and surgical skills were identified. Only 42.3% of respondents were confident in their ability to diagnose obstructed labour, 26.3% had performed an assisted delivery, 39.0% were confident in their knowledge of the indications and contraindications of assisted deliveries and 35.7% had been involved in the delivery of a baby with shoulder dystocia. Regarding pregnancy related sepsis, 54.4% had experience with managing a wound abscess and 29.7% were confident managing puerperal endometritis. While 78.0% felt confident to perform a caesarean section, only 28.6% had performed uterine compression sutures for uterine atony at caesarean section. Additionally, there was a statistically significant variation in scores between training hospitals. Conclusion: A gap exists between the shortcomings in district hospital obstetric services, the prioritisation of placement of community service doctors at primary care and district hospitals, and the self-perceived readiness of medical interns completing their training to safely manage obstetric emergencies. This highlights the importance of clinical support for junior doctors at district hospitals and standardisation of intern training at accredited facilities across the country. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-02
Assessing South African Medical Interns’ Experience and Confidence in Managing Obstetric Emergencies
- Authors: Miller, Andrew
- Date: 2021-02
- Subjects: Obstetrical emergencies
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6882 , vital:52352
- Description: Background: Medical doctors in South Africa are required to complete a two-year internship at training hospitals, including a four-month rotation in obstetrics and gynaecology. Following this, doctors are allocated to community service posts; many of which are at district and primary level facilities where supervision is limited. The latest triennial Saving Mothers Report identified district hospitals as the second leading site for maternal deaths of all causes. District hospital were also the leading site for maternal deaths secondary to obstetric haemorrhage and the most likely site for the lack of a skilled doctor to be identified as a factor in deaths associated with caesarean delivery. Methods: This cross-sectional descriptive study aimed to describe the self-perceived readiness of medical interns completing their training to independently manage obstetric emergencies, based on the ESMOE modules in the HPCSA internship logbook. The research assessed medical interns in the last three months of their training, using a self-administered online questionnaire, with data collection between October and December 2019. Cluster sampling of interns at training facilities throughout the country resulted in a total of 182 respondents from 17 hospitals in seven provinces in the country, with an overall response rate of 34.1%. Results: Most interns had experience with, and confidence in, the management of miscarriage and hypertension in pregnancy. However, gaps in labour ward management, pregnancy related sepsis and surgical skills were identified. Only 42.3% of respondents were confident in their ability to diagnose obstructed labour, 26.3% had performed an assisted delivery, 39.0% were confident in their knowledge of the indications and contraindications of assisted deliveries and 35.7% had been involved in the delivery of a baby with shoulder dystocia. Regarding pregnancy related sepsis, 54.4% had experience with managing a wound abscess and 29.7% were confident managing puerperal endometritis. While 78.0% felt confident to perform a caesarean section, only 28.6% had performed uterine compression sutures for uterine atony at caesarean section. Additionally, there was a statistically significant variation in scores between training hospitals. Conclusion: A gap exists between the shortcomings in district hospital obstetric services, the prioritisation of placement of community service doctors at primary care and district hospitals, and the self-perceived readiness of medical interns completing their training to safely manage obstetric emergencies. This highlights the importance of clinical support for junior doctors at district hospitals and standardisation of intern training at accredited facilities across the country. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-02
Assessing the risk factors of Coronary heart disease among rural adults in the Joe Gqabi District: Eastern Cape
- Authors: Tetana, Thando
- Date: 2016
- Subjects: Cardiovascular disease Coronary heart disease -- South Africa -- Eastern Cape Coronary heart disease--Risk factors
- Language: English
- Type: Thesis , Masters/Doctoral , M Sc Public Health
- Identifier: http://hdl.handle.net/11260/1440 , vital:35587
- Description: Cardiovascular disease (CVD) such as coronary heart disease (CHD) is a contributing factor to a large percentage of mortalities and morbidities worldwide including in affluent South African setting. In the Eastern Cape of Province, South Africa, there is no extensive data reported on Coronary Heart Disease (CHD) determinants and risk factors. The present study sought to assess the risk factors and determinants of CHD. This case (n=50) control (n=50) study matched for sex and age, was conducted among Xhosa adults from rural and semi urban/ township areas of Joe Gqabi District, Eastern Cape Province of South Africa. Non modifiable, environmental, lifestyle, and psychological factors were investigated using univariate analysis and multivariate logistic regression analysis. Depression, alcohol excessive intake, family history of CHD were the CHD univariate risk factors. The independent risk factors of CHD were uncontrolled systolic hypertension (Odds Ratio (OR)=95; 95% Confidence Interval 16.9-128; In front of a multifactorial disease driven by interactions of socio determinants and traditional risk factors, urgent programmes of education, clinical management and health promotion for adequate diet, physical activity, adherence and compliance to medication and are needed to curb epidemic proportions of CVD risk factors.
- Full Text:
- Date Issued: 2016
- Authors: Tetana, Thando
- Date: 2016
- Subjects: Cardiovascular disease Coronary heart disease -- South Africa -- Eastern Cape Coronary heart disease--Risk factors
- Language: English
- Type: Thesis , Masters/Doctoral , M Sc Public Health
- Identifier: http://hdl.handle.net/11260/1440 , vital:35587
- Description: Cardiovascular disease (CVD) such as coronary heart disease (CHD) is a contributing factor to a large percentage of mortalities and morbidities worldwide including in affluent South African setting. In the Eastern Cape of Province, South Africa, there is no extensive data reported on Coronary Heart Disease (CHD) determinants and risk factors. The present study sought to assess the risk factors and determinants of CHD. This case (n=50) control (n=50) study matched for sex and age, was conducted among Xhosa adults from rural and semi urban/ township areas of Joe Gqabi District, Eastern Cape Province of South Africa. Non modifiable, environmental, lifestyle, and psychological factors were investigated using univariate analysis and multivariate logistic regression analysis. Depression, alcohol excessive intake, family history of CHD were the CHD univariate risk factors. The independent risk factors of CHD were uncontrolled systolic hypertension (Odds Ratio (OR)=95; 95% Confidence Interval 16.9-128; In front of a multifactorial disease driven by interactions of socio determinants and traditional risk factors, urgent programmes of education, clinical management and health promotion for adequate diet, physical activity, adherence and compliance to medication and are needed to curb epidemic proportions of CVD risk factors.
- Full Text:
- Date Issued: 2016
Assessment of compliance to the maintenance procedure of medical equipment in a selected hospital, Oliver Reginald Tambo District, Eastern Cape Province
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Assessment of the effect of the down-referral chronic medication distribution system on patients' adherence to chronic medication in the Buffalo City sub-district
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
- Full Text:
- Date Issued: 2018
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
- Full Text:
- Date Issued: 2018
Assessment of the implementation of workplace HIV/AIDS programmes in the public and private sectors of Mount Fletcher in the Eastern Cape Province, Republic of South Africa
- Ndhlovu-Nomatshila, Zanele Benedict
- Authors: Ndhlovu-Nomatshila, Zanele Benedict
- Date: 2012
- Subjects: HIV/AIDS awareness South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , M Sw
- Identifier: vital:18480 , http://hdl.handle.net/11260/d1011521
- Description: Workplaces are required by law to provide HIV and AIDS workplace programmes to educate and prevent the spread of HIV, and stigmatisation and discrimination against workers infected or affected by HIV and AIDS. This study was a descriptive cross-sectional study conducted in the public and private sector at Mt Fletcher in the Eastern Cape Province. It aimed at assessing the availability and implementation of HIV and AIDS workplace programmes at Mt Fletcher. The study’s objectives were: to assess knowledge of HIV and AIDS among employees; to determine the availability of HIV and AIDS psychosocial programmes; to assess the employees’ knowledge on HIV and AIDS workplace guidelines that prevent stigma and discrimination. This was a quantitative study. A self-administered questionnaire was used to collect data. A total of 81 respondents from both public and private sectors participated in the study. Stratified random sampling was used to select participating workplaces. Simple random sampling was used to select respondents. The findings indicated that both public and private sector workplaces have HIV and AIDS programmes. However, all private sector workplaces at Mt Fletcher had no onsite clinic as required, but use the local public HIV and AIDS clinics. However, 24% of public and 23% of private sector employees had no knowledge of the existence of the HIV and AIDS programmes at their workplaces. About 13% of public and 10% of private sector employees indicated that stigmatisation and discrimination against people living with HIV and AIDS was a problem in the workplace. They also indicated that they would not disclose their HIV status to their employers because they were afraid of losing their jobs. The lack of disclosure further disadvantages workers living with HIV as they do not get the support they deserve from their employers. Furthermore, lack of support, stigma and discrimination have an impact on the performance and productivity of the infected and affected employees and therefore affecting the expected output of their workplaces.
- Full Text:
- Date Issued: 2012
- Authors: Ndhlovu-Nomatshila, Zanele Benedict
- Date: 2012
- Subjects: HIV/AIDS awareness South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , M Sw
- Identifier: vital:18480 , http://hdl.handle.net/11260/d1011521
- Description: Workplaces are required by law to provide HIV and AIDS workplace programmes to educate and prevent the spread of HIV, and stigmatisation and discrimination against workers infected or affected by HIV and AIDS. This study was a descriptive cross-sectional study conducted in the public and private sector at Mt Fletcher in the Eastern Cape Province. It aimed at assessing the availability and implementation of HIV and AIDS workplace programmes at Mt Fletcher. The study’s objectives were: to assess knowledge of HIV and AIDS among employees; to determine the availability of HIV and AIDS psychosocial programmes; to assess the employees’ knowledge on HIV and AIDS workplace guidelines that prevent stigma and discrimination. This was a quantitative study. A self-administered questionnaire was used to collect data. A total of 81 respondents from both public and private sectors participated in the study. Stratified random sampling was used to select participating workplaces. Simple random sampling was used to select respondents. The findings indicated that both public and private sector workplaces have HIV and AIDS programmes. However, all private sector workplaces at Mt Fletcher had no onsite clinic as required, but use the local public HIV and AIDS clinics. However, 24% of public and 23% of private sector employees had no knowledge of the existence of the HIV and AIDS programmes at their workplaces. About 13% of public and 10% of private sector employees indicated that stigmatisation and discrimination against people living with HIV and AIDS was a problem in the workplace. They also indicated that they would not disclose their HIV status to their employers because they were afraid of losing their jobs. The lack of disclosure further disadvantages workers living with HIV as they do not get the support they deserve from their employers. Furthermore, lack of support, stigma and discrimination have an impact on the performance and productivity of the infected and affected employees and therefore affecting the expected output of their workplaces.
- Full Text:
- Date Issued: 2012
Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape : views of students and educators
- Terblanche, Delcia Jill Nora
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching AIDS (Disease) -- Prevention Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching AIDS (Disease) -- Prevention Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Date Issued: 2018