Browsing by Author "Taylor, Myra."

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Adherence to antiretroviral therapy by HIV infected patients in rural UMkhanyakude District, South Africa.
(2008) Mthiyane, Italia Nokulunga.; Taylor, Myra.
The background. HIV and AIDS is a huge problem in sub-Saharan Africa where an estimated 22.5 million people were living with HIV in 2007.1 South Africa has the worst epidemic in the world.1 There were about 5.5 million people living with HIV and 1000 AIDS deaths daily in South Africa by the end of 2005.17 In 2007 the number of people living with HIV in South Africa increased to 5.7 million.1 The HIV prevalence in Umkhanyakude district, KwaZulu Natal, where Hlabisa subdistrict is situated, amongst public antenatal clinic attenders was 39.8% in 2007.19 AIDS is the cause of 50.0% of deaths in the Hlabisa sub-District.15 In 2003 the South African government decided to provide antiretroviral therapy (ART) in the public health sector, giving hope to thousands of people who are in need of this intervention to improve their quality of life and reduce premature deaths.7,13 However adherence to antiretroviral drugs is essential for successful treatment. Adherence to antiretroviral therapy in South Africa as in other African countries was expected to be low31 (<95.0%), however, in a study that was done in Cape Town during 1996 – 2001, the authors concluded that adherence was high.28 The aim of that study was to identify predictors of low adherence (<95.0%) and failure of viral suppression (>400 HIV copies/mm3). Pill counts and records of treatment refills from pharmacy were used to measure adherence.28 The results revealed no significant difference in adherence between patients on protease inhibitor based regimens and/or those on nonnucleoside based regimens nor with socioeconomic status, sex and HIV stage. Independent predictors of low adherence were English language speaking, age, and three times per day dosing. The following were found to be independent predictors of failure of viral suppression: baseline viral load, <95.0% adherence, age and dual nucleoside therapy.28This study however was done in an urban area before the antiretroviral therapy (ART) roll out in South Africa when the cost of treatment limited the accessibility of ART. These patients may have been different to patients who access free treatment in public health facilities today. Other South African studies have also reported good adherence rates.39,40 In another study in Soweto, South Africa, adherence was high, 88.0% of patients achieved > 95.0% goal, 9.0% achieved 90.0-95.0% adherence and only 3.0% achieved <90.0%.39In a study done at Khayelitsha, adherence was also high, viral load level was < 400 in 88.1%, 89.2%, 84.2%, 75% and 69.7% of patients at 3, 6, 12, 18 and 24 months.40 However, Soweto and Khayelitsha are urban and different from Hlabisa, and it is difficult to generalize these results to the sub-district. This study intended to assess how adherent patients are to antiretroviral therapy in a typical rural district in order to inform policy to enhance adherence to ART.
Adherence-monitoring practices by private healthcare sector doctors managing HIV and AIDS patients in the eThekwini metro of KwaZulu-Natal.
(MedPharm, 2009) Naidoo, Panjasaram.; Taylor, Myra.; Jinabhai, Champaklal Chhaganlal.
Background: The danger of poor adherence to treatment by patients with HIV infection is that poor adherence correlates with clinical and virological failure. Understanding how private-sector doctors monitor adherence by their HIV-infected patients could assist in developing interventions to improve adherence by these patients. Information about such practices amongst private-sector doctors in the province of KwaZulu-Natal, however, is limited. This study was, therefore, undertaken to assess the private-sector doctor adherence-monitoring practices of HIV-infected patients in the eThekwini metro of KwaZulu-Natal. Methods: A descriptive cross-sectional study was undertaken amongst private general practitioners (GPs) and specialists managing HIV/AIDS patients in the eThekwini metro. Anonymous semi-structured questionnaires were used to investigate adherence-monitoring practices by these doctors and their strategies to improve adherence. Results: A total of 171 doctors responded, with over 75% in practice for over 11 years and 78.9% indicating that they monitored adherence. A comparison between the GPs and the specialists found that 82.6% of the GPs monitored adherence compared with 63.6% of the specialists (p = 0.016). The doctors used several approaches, with 60.6% reporting the use of patient self-reports and 18.3% reporting the use of pill counts. A total of 68.7% of the doctors indicated that their adherence monitoring was reliable, whilst 19.7% indicated that they did not test the reliability of their monitoring tools. The most common strategy used to improve adherence by their patients was through counselling. Other strategies included alarm clocks, SMSs, telephone calls to the patients, the encouragement of family support and the use of medical aid programmes. Conclusions: Private-sector doctors managing HIV/AIDS patients in the eThekwini metro of KwaZulu-Natal do monitor adherence and employ strategies to improve adherence.
The association of organizational contextual factors and HIV-Tuberculosis service integration following exposure to quality improvement interventions in primary healthcare clinics in rural KwaZulu-Natal.
(2021) Gengiah, Santhanalakshmi.; Loveday, Marian Patricia.; Taylor, Myra.
A key strategy to reduce Tuberculosis (TB)-related mortality among people living with HIV is integrating HIV and TB diagnostic and treatment services. In South Africa, integrated HIV-TB service provision is standard of care, however, there is evidence that patients accessing primary healthcare clinics (PHC) are missed for HIV and TB testing and screening, diagnosis, linkage to treatment, and preventive services. Gaps in the HIV-TB care cascade are indicative of weaknesses in healthcare systems at the frontline. Quality Improvement (QI) collaboratives are a widely adopted approach to facilitating improvement among multiple clinics and scaling up best practices to improve on a given health topic. Little is known of the effectiveness of QI collaboratives and less is known of the role of organizational contextual factors (OCFs) in influencing the success of QI collaboratives to improve integrated HIV-TB services. Scaling up TB/HIV Integration (SUTHI) was a cluster-randomised trial designed to test the effectiveness of a QI intervention to enhance integrated HIV-TB services on mortality in HIV, TB, and HIV-TB patients. The study was from 01 December 2016-31 December 2018. Sixteen nurse supervisors (clusters) overseeing 40 PHC clinics were randomized (1:1) to receive either a structured QI intervention (QI group), which comprised, clinical training, three QI workshops timed at 6-month intervals, and in-person mentorship visits; or standard of care (SOC group) supervision and support for HIV-TB service delivery. This PhD project was a nested sub-study embedded in the SUTHI trial which aimed to describe and assess the influence of OCFs on the QI intervention to improve process indicators of HIV-TB services. A description of the QI intervention, including change ideas generated and lessons learned from practical application of the intervention in 20 QI clinics are presented in Paper I. Baseline performance of indicators was highlighted as important in influencing the size of improvements. OCFs that undermined the QI process were poor data quality, data capturing backlogs, lack of data analytic skills among clinic staff, poor transfer of training knowledge to peers, low clinic staff motivation to consistently track performance and limited involvement of the clinic management team in QI activities due to heavy workloads. A comparison between the QI and SOC group clinics showed that the QI intervention was only effective in improving two of five HIV-TB indicators, HIV testing services (HTS) andIsoniazid Preventive Therapy (IPT) initiation rates in new antiretroviral therapy patients. HTS was 19% higher (94.5% versus (vs) 79.6%; Relative Risk (RR)=1.19; 95% CI:1.02% - 1.38%; p=0.029) and IPT initiation was 66% higher (61.2% vs 36.8%; RR=1.66; 95% CI:1.02% -2.72%; p=0.044), in the QI group compared to the SOC group. Small clusters showed larger improvements in IPT initiation rates compared to big clusters, likely due to better coordination of efforts (Paper II). Several OCFs were quantitatively assessed and inserted into a linear mixed model to determine which factors likely influenced the improvement observed in the IPT initiation rates (Paper III). The practice of monitoring data for improvement was significantly associated with higher IPT initiation rates (Beta coefficient (β)=0.004; p=0.004). The main recommendations made from the PhD project are to encourage the practice of monitoring data for improvement among clinic teams; provision of widespread QI training for all levels of staff, different staff categories and leadership; to ensure good quality of routine data, and provision of regular performance feedback from upper management to the clinics.
The effect of improved water and sanitation on the prevalence of schistosomiasis and soil transmitted helminths (STH) amongst female primary school aged children in Ugu District of KwaZulu-Natal, South Africa.
(2014) Zulu, Siphosenkosi Gift.; Taylor, Myra.
Background: Inadequate water supply and sanitation adversely affect the health and socio-economic development of communities and place them at risk of contracting S. haematobium and soil transmitted helminths (STH). AIM. The aim of the study was to determine if improved water and sanitation infrastructure has had an impact on the prevalence and intensity of schistosomiasis and soil transmitted helminths in female pupils aged 10-12 years attending primary schools in Ugu district, KwaZulu-Natal. METHODS. A descriptive cross-sectional study was conducted in Ugu district amongst primary school pupils from 18 randomly selected. Kato-Katz and urine centrifugation techniques were used to analyze stool and urine samples respectively. A structured questionnaire was used to collect water contact information, and one stool sample and three consecutive day’s urine samples, were collected from each participant. Information on sanitation and water infractructure in communities was obtained through interviews with community ward councillors. Same analysis were done on the data from 1998 Parasite Control Programme (PCP) and findings used to compare with current study’s findings. Results. Amongst the 1057 pupils interviewed, prevalence of Ascaris lumbricoides and Trichuris trichiura was 25% and 26% respectively, and corresponding mean intensities of infections were 21 and 26 eggs per gram. The prevalence of Schistosoma haematobium was 32.2% and the mean intensity of infection was 60 eggs/10ml. When asked whether pupils knew about schistosomiasis, whether they had had red urine in the past week and if they had ever had dysuria, 60%, 9% and 22% respectively, answered in the affirmative. The 15 Ugu ward councillors reported improved access to safe water and sanitation. CONCLUSION. Improved service delivery is likely to have contributed to reduced prevalence of STHs. However, a third of the study samples and a quarter of the study sample was infected with S. haematobium and STHs respectively.
Evaluation of the clinical and drug management of HIV/AIDS patients in the private health care sector of the eThekwini Metro of KwaZulu-Natal : sharing models and lessons for application in the public health care sector.
(2010) Naidoo, Panjasaram.; Jinabhai, Champaklal Chhaganlal.; Taylor, Myra.
Introduction: South Africa is currently experiencing one of the most severe AIDS epidemics in the world with South Africa‘s public sector under great stress and under-resourced whilst there exists a vibrant private healthcare sector. Private healthcare sector doctors have a pivotal role to play in the management of HIV and AIDS infection. However not much is known about the extent of private healthcare sector doctor involvement in the management of HIV and AIDS patients. In addition these doctors need to have an accurate knowledge of the management of the infection, and a positive attitude towards the treatment of persons with HIV and AIDS. With the availability of antiretroviral drugs only since around 1996, many of the doctors who were trained prior to 1996 would not have received any formal training in the management of HIV and AIDS patients, further it is very important that these doctors constantly update their knowledge and obtain information in order to practise high-quality medicine. Although private sector doctors are the backbone of treatment service in many countries, caring for patients with HIV brings a whole new set of challenges and difficulties. The few studies done on the quality of care of HIV patients, in the private sector in developing countries, have highlighted some problems with management thus it becomes important to ascertain these doctors‘ training needs together with where these doctors source information on HIV/AIDS to stay updated. In South Africa two thirds of the doctors work in the private sector. To address some of the resource and personnel shortages facing the public sector in South Africa, partnerships between the public and private sectors are slowly being forged. However, little is known about the willingness on the part of private sector doctors in the eThekwini Metro of KwaZulu-Natal, to manage public sector HIV and AIDS patients. Though many studies have been undertaken on HIV/AIDS, fewer have been done in the private sector in terms of the management of this disease which includes doctors‘ adherence monitoring practices, their training needs and sources of information and their willingness to manage public sector patients. A study was therefore undertaken to assess the involvement of private sector doctors in the management of HIV, their training needs and sources of HIV information, the quality of HIV clinical management that they provided, together with their strategies for improving adherence in patients. Further the study assessed factors that affect adherence in patients attending private healthcare, and finally investigated whether private sector doctors are willing to manage public sector HIV infected patients. A literature review of the barriers that prevent doctors from managing HIV/AIDS patients was also undertaken. Method: A descriptive cross sectional study was undertaken using structured self reported questionnaires. All private sector doctors practising in the eThekwini Metro were included in the study. The study was divided into different phases. After exclusions a valid sample of 931 participants was obtained in Phase 1. However only 235 of these doctors indicated that they managed HIV infected patients, of which only 190 consented to be part of Phase 2 of the study. In Phase 2 the questionnaires were administered by trained field workers to the doctors after confirming doctors‘ consent. The questionnaires were thereafter collected, the data captured and analysed using SP55 version 15. Results: Although 235 (71.6%) doctors managed HIV and AIDS patients, 93 (28.4%) doctors did not, and of the latter 48 (51.61%) had not encountered HIV and AIDS patients, twenty five (26.88%) referred such patients to specialists, six (6.45%) cited cost factors as reasons for not treating such patients, whilst twelve (12.90%) doctors, though they indicated that there were other reasons for not managing HIV infected patients, did not specify their reasons. Two doctors (2.15%) indicated that due to inadequate knowledge they did not manage HIV and AIDS patients. Significantly younger (recently qualified) doctors rather than older (qualified for more years) doctors treated HIV/AIDS patients (p<0.001). Most doctors (76.3%) expressed a need for more training/knowledge on the management of HIV patients. Eighty five doctors (54.5%) always measured the CD4 count and viral load levels at diagnosis. Both CD4 counts and viral load were always used by 76 doctors (61.8%) to initiate therapy. Of the doctors 134 (78.5%) initiated therapy at CD4 count < 200cells/mm3. The majority of doctors prescribed triple therapy regimens using the 2 NRTI +1 NNRTI combination. Doctors who used CD4 counts tended to also use viral load (VL) to assess effectiveness and change therapy (p<0.001). At initiation of treatment 68.5% of the doctors saw their patients monthly and 64.3% saw them 3-6 monthly when stable. The majority of the doctors (92.4%) obtained information on HIV and AIDS from journals. Continuing Medical Education (CME), textbooks, pharmaceutical representatives, workshops, colleagues and conferences were identified as other sources of information, while only 35.7% of doctors were found to use the internet for information. GPs and specialists differed significantly with regard to their reliance on colleagues (52.9% versus 72.7%; p < 0.05) and conferences (48.6% versus 78.8%; p < 0.05) as sources of HIV information. Of the respondents, 78.9% indicated that they monitor for adherence. Comparison of GPs and specialists found that 82.6% of the GPs monitor for adherence compared to 63.6% of the specialists. (p=0.016). Doctors used several approaches with 60.6% reporting the use of patient self reports and 18.3% pill counts. Doctors (68.7%) indicated that their adherence monitoring is reliable, whilst 19.7% stated they did not test the reliability of their monitoring tool. The most common strategy used to improve adherence of their patients was by counseling. Other strategies included alarm clocks, SMS, telephoning the patient, encouraging family support and the use of medical aid programmes. One hundred and thirty three (77.8%) doctors were willing to manage public sector HIV and AIDS patients, with 105 (78.9%) reporting adequate knowledge, 99 (74.4%) adequate time, and 83 (62.4%) adequate infrastructure. Of the 38 (22.2%) that were unwilling to manage these patients, more than 80% cited a lack of time, knowledge and infrastructure to manage them. Another reason cited by five doctors (3.8%) who were unwilling was the distance from public sector facilities. Of the 33 specialist doctors, 14 (42.4%) indicated that they would not be willing to manage public sector HIV and AIDS patients, compared with only 24 (17.4%) of the 138 GPs (p < 0.01). There was no statistical difference between adherence to treatment and demographics of the respondent patient such as age, gender and marital status. In this study 89.1% of patients were classified as non-adherent and reasons for non-adherence included difficulty in swallowing medicines (67.3%) (p = 0.01); side effects (61.8%) (p = 0.03); forgetting to take medication (58.2%) (p = 0.003); and not wanting to reveal their HIV status (41.8%) (p = 0.03). Common side effects experienced were nausea, dizziness, insomnia, tiredness or weakness. Reasons for taking their medicines included that tablets would save their lives (83.6%); they understood how to take the medication (81.8%); tablets would help them feel better (80.0%); and that they were educated about their illness (78.2%). All participants that were on a regimen that comprised protease inhibitors and two NRTIs were found to be non-adherent. Conclusion: All doctors in the private healthcare sector were not involved in the management of HIV/AIDS patients. Doctors indicated that they required more training in the management of HIV/AIDS patients. However private sector doctors in the eThekwini Metro do obtain information on HIV from reliable sources in order to have up-to-date knowledge on the management of HIV-infected patients, with the majority of private sector doctors being compliant with the current guidelines, hence maintaining an acceptable quality of clinical health care. These doctors do monitor for adherence and employ strategies to improve adherence in their patients who do have problems adhering to their treatment due to various factors. Many private sector doctors are willing to manage public sector HIV and AIDS patients in the eThekwini Metro, potentially removing some of the current burden on the public health sector.
Evaluation of the clinical management of HIV-infected patients by private sector doctors in the eThekwini Metro, KwaZulu-Natal.
(MedPharm, 2009) Naidoo, Panjasaram.; Esterhuizen, Tonya.; Jinabhai, Champaklal Chhaganlal.; Taylor, Myra.
Background: Although private sector doctors are the backbone of treatment service in many countries, caring for patients with HIV entails a whole new set of challenges and difficulties. The few studies done on the quality of care of HIV patients, in the private sector in developing countries, have highlighted some problems with management. In South Africa, two-thirds of doctors work in the private sector. Though many studies on HIV/AIDS have been undertaken, few have been done in the private sector in terms of the management of this disease. Therefore, a study was undertaken to evaluate the clinical management of HIV-infected patients by private sector doctors. Methods: A descriptive cross-sectional study was undertaken in the eThekwini Metro in KwaZulu-Natal, South Africa, with 190 private sector doctors who, in the first phase of the study, indicated that they manage HIV and AIDS patients and would be willing to participate in the second phase of the study. The HIV guidelines of the Department of Health and Human Services and the South African National Department of Health were used to compare the treatment of HIV patients by these doctors. Results: Eighty-five doctors (54.5%) always measured the CD4 count and viral load levels at diagnosis. Both CD4 counts and viral load were always used by 76 doctors (61.8%) to initiate therapy. Of the doctors, 134 (78.5%) initiated therapy at CD4 count < 200 cells/mm3. The majority of doctors prescribed triple therapy regimens using the 2 NRTI + 1 NNRTI combination. Doctors who utilised CD4 counts tended to also use viral load (VL) to assess effectiveness and change therapy (p < 0.001). At initiation of treatment, 68.5% of the doctors saw their patients monthly and 64.3% saw them every three to six months, when stable. Conclusion: The majority of private sector doctors were compliant with current guidelines for HIV management, hence maintaining an acceptable quality of clinical healthcare.
An exploration of the phenomena of multiple addictions and addiction interaction disorder in Durban, South Africa.
(2013) Keen, Helen.; Sathiparsad, Reshma.; Taylor, Myra.
Addiction to drugs is a widely acknowledged problem in South Africa. Newer developments in the study of addiction include behaviours such as gambling and sex as part of a broader syndrome. International research has established that most people with one addiction are at risk for co-occurring addictions which are frequently undiagnosed and untreated. Multiple addictions (MA) have been shown to combine in specific patterns to produce addiction interaction disorder (AID) resulting in a more complex, treatment- resistant illness. This was the first study South Africa to investigate if people with substance use disorders had other addictions. The research had three aims: to establish if in-patients admitted to three drug rehabilitation centres had other addictions, to investigate the extent of the MA and AID and to determine whether the treatment programmes managed them appropriately. The study employed the mixed methods research design and was located at three in-patient facilities in Durban, KwaZulu-Natal. During the first phase, discussion groups were held with professionals that explored their perceptions of MA, AID and current treatment programmes. The second phase involved a survey of 123 participants screened for poly-substance abuse, sex (including internet) addiction and problem gambling. The third phase utilised in-depth interviews with 25 participants displaying MA to understand the development of addiction, AID and treatment received. The data were analysed utilising descriptive and statistical analysis for the survey data, and thematic analysis for the in-depth interviews and discussion groups. The study found a high incidence of MA within the survey population of 54%; 37% of participants tested positive or at risk for problem gambling and 41% tested positive for sex addiction with 24% of the participants being positive for both. In-depth interviews revealed high rates of trauma, especially for the female participants and demonstrated the complex interrelationship between addictions. AID was identified in all 25 participants. In KwaZulu- Natal, it appears that MA and AID are currently not being assessed or treated. The study highlights the need for a broader conceptualisation of addiction which would improve current assessment and treatment and has implications for further training of professionals and addiction policy in South Africa.
Exploring cultural norms, masculinities and sexual behaviours of black South African male students at the University of KwaZulu-Natal = Ukuhlola amasiko, ubudoda kanye nokuziphatha kocansi kwabafundi besilisa abamnyama baseNingizimu Afrika eNyuvesi yaKwaZulu-Natal.
(2021) Khumalo, Sinakekelwe Khanyisile.; Mabaso, Musawenkosi Lionel.; Taylor, Myra.
Background: Research evidence indicates that African male students are more likely to engage in risky sexual behaviour than their female counterparts. Sexual behaviour among male students is to a large extent influenced by their individual decisions and the social environment including immediate family and surrounding communities. It is therefore important to understand the context under which sexual behaviours are constructed and shaped. For many young people, the university environment period provides a critical developmental transition from adolescence to adulthood, during which young people establish patterns of behaviours and make lifestyle choices that affect both their current and future health. It is within this setting that young men interrogate their masculinities and sexual behaviours. The explanation of male students’ sexual behaviours can be determined through understanding the meaning and influence that they attach to the cultural norms related to sexual behaviours. Using the social constructionist paradigm that examines the development of masculinities as a mutual construct of individual, social, cultural, and historical contexts, the study aimed to explore cultural norms, masculinities and sexual behaviour of Black male students. This understanding is essential in order to develop recommendations to promote positive sexual behaviour messaging for university male students. The specific objectives of this study were (1) to explore how Black African male university students construct their sexual behaviours, (2) to explore the cultural norms associated with Black South African male students’ sexual behaviours, and (3) to explore the influence of the university behavioural intervention programmes on the sexual behaviours of male students. Methods: The study population was selected using purposive sampling. Data were collected using four focus group discussions with 36 participants and three key informant interviews. Focus group discussions consisted of 8-10 participants and were conducted according to the current year of study of the students. Thematic analysis was utilized to identify the key patterns and the themes that emerged from the data. Results: The results of the study reveal that versions of masculinities at institutions of higher learning are socially constructed, fluid over time and plural. An individual has multiple masculinities which are often exerted to suit their current discourse at any given point. The university setting appeared to be a space where a lot of toxic masculinities and sexual risk-taking occurred, which potentially exposed the young men in the study to sexually transmitted infections such as HIV. The results further reveal that the other influences on the sexual behaviours of the young men included family, peers and community. It was also discovered that poor knowledge and awareness, negative perceptions and attitudes, fear and lack of privacy, and negative experiences are the factors that lead to poor access and utilization of campus health services. Conclusion: The university space is an important space that allows young men from different cultural backgrounds to explore their masculinities, sexualities and sexual behaviours. The cultural norms of black male students studying at university which are associated with masculinities, sexualities and sexual behaviours are influenced by an array of factors such as family, peers, community, and individual decisions. These factors shape and ultimately inform the behaviours of young men regarding their masculinities and sexual behaviours. A number of male students continue to delay or avoid seeking health care even with the available sexual health programs at the university. It is therefore essential that the university’s HIV and AIDS programs infuse socio-cultural norms and notions of masculinity in their health communication strategy to create more effective HIV prevention programs for young men. Iqoqa Isendlalelo: Ukuziphatha ngokocansi kwabafundi besilisa ngokwezinga elikhulu kuthonywa izinqumo zabo ngabanye kanye nendawo yenhlalo kubandakanya umndeni oseduze kanye nemiphakathi ebazungezile. Ngakho-ke kubalulekile ukuqonda umongo lapho ukuziphatha kocansi kwakhiwe futhi akheke ngaphansi kwaso. Intsha eningi, isikhathi sendawo yasenyuvesi sihlinzeka ngoshintsho olubalulekile lwentuthuko ukusuka ebusheni kuya ekubeni abantu abadala, lapho abantu abasha besungula amaphethini okuziphatha futhi benze ukukhetha kwendlela yokuphila okuthinta impilo yabo yamanje neyesikhathi esizayo. Kukulesi simo lapho izinsizwa ziphenya khona ngobudoda nokuziphatha kwazo ngokocansi. Izindlela: Inani labantu bocwaningo likhethwe kusetshenziswa amasampula okuhlosiwe. Imininingo yaqoqwa kusetshenziswa izingxoxo zamaqembu amane okugxilwe kuwo nabahlanganyeli abangama-36 kanye nezingxoxo ezintathu ezibalulekile zabanolwazi. Izingxoxo zeqembu okugxilwe kuzo bezinabahlanganyeli abangu-8-10 futhi zaqhutshwa ngokonyaka wamanje wokufunda wabafundi. Ukuhlaziywa kwendikimba kusetshenziswe ukuze kutholakale amaphethini abalulekile nezindikimba ezivele emininingweni. Imiphumela: Imiphumela yocwaningo iveza ukuthi izinhlobo zabesilisa ezikhungweni zemfundo ephakeme zakhiwe ngokwenhlalo, zishintshashintsha ngokuhamba kwesikhathi kanye nobuningi. Umuntu unezinto eziningi zesilisa ezivame ukusetshenziswa ukuze zivumelane nenkulumo yakhe yamanje nganoma yisiphi isikhathi. Imiphumela iphinde iveze ukuthi amanye amathonya ekuziphatheni kocansi kwezinsizwa kwakuhlanganisa umndeni, ontanga kanye nomphakathi. Kuphinde kwatholakala ukuthi ulwazi olubi nokuqwashisa, imibono engemihle nezimo zengqondo, ukwesaba nokuntula imfihlo, kanye nolwazi olubi yizinto eziholela ekufinyeleleni okubi nasekusetshenzisweni kwezinsizakalo zezempilo zesikhungo. Isiphetho: Indawo yasenyuvesi iyindawo ebalulekile evumela izinsizwa eziqhamuka ezindaweni ezahlukene zamasiko ukuthi zihlole ubudoda bazo, ubulili kanye nokuziphatha kwazo ngokocansi. Idlanzana labafundi besilisa liyaqhubeka nokulibazisa noma ligweme ukufuna usizo lwezempilo ngisho nezinhlelo zezempilo zocansi ezikhona enyuvesi. Ngakho-ke kubalulekile ukuthi izinhlelo zenyuvesi ze-HIV ne-AIDS zifake imikhuba yezenhlalo namasiko kanye nemibono yobudoda esu labo lezempilo lokuxhumana ukuze bakhe izinhlelo ezisebenza ngempumelelo zokuvikela i-HIV ezinsizweni. Amagama asemqoka: amasiko, ukuziphatha kocansi, ubudoda, abafundi besilisa abasebasha, inyuvesi, eNingizimu Afrika
Health science faculty employees' perceptions of organisational culture in the merger of the University of Durban-Westville and the University of Natal.
(2010) Pillay, Shamla Devi.; Taylor, Myra.
No abstract available.
An HIV/AIDS prevention intervention among high school learners in South Africa.
(2008) Frank, Serena V.; Taylor, Myra.; Jinabhai, Champaklal Chhaganlal.
Introduction Nearly half of all new HIV infections worldwide occur in young people aged 15-24 years. Risky sexual behaviours may lead to the development of lifelong negative habits like having multiple partners, thereby placing young people at risk of a broad range of health problems, including HIV/AIDS. Prevention is therefore critical and includes changing behaviours that are risky, such as the early age of sexual initiation, having many sexual partners and non-use of condoms. The study aimed to evaluate whether a theory based HIV/AIDS intervention, 'Be A Responsible Teenager' (B.A.R.T.), could produce behaviour change among high school learners in South Africa. Methods A pre-test /multiple post-test intervention study was undertaken. All Grade 10 learners (n = 805) from all three public high schools in Wentworth were included in the study. Eleven teachers were interviewed from these schools. Learners completed a questionnaire at baseline (Tl), immediately post intervention 1 (T2), post intervention 2 (T3) and after a period of seven months (T4). The B.A.R.T.intervention was implemented in the intervention schools while the control group did not receive any intervention. Qualitative data was analyzed according to themes, while quantitative data was analyzed cross sectionally and longitudinally. Results Teachers reported many obstacles in implementing the HIV/AIDS Life Skills' curriculum, including the poor quality of training and inadequate resources in schools. Further, learners practised high-risk sexual behaviours. Gender differences in sexual behaviour were reported with males predominately practising higher risk behaviours than females.The B.A.R.T. intervention did show changes in behaviour for alcohol use at last sex and for the determinants knowledge, attitudes, beliefs, self-efficacy and intentions to practise safer sex respectively, over time. However, the intervention didnot positively impact abstinence behaviours, condom use and the reduction in partners. Further, subjective norms did not change. Conclusion The major obstacles to AIDS prevention include the current practices of risky sexual behaviours including age mixing, early sexual initiation, multiple partners, forced sex and receiving money or gifts for sex among others. Social norms as potrayed by parents, peers and religious groups play a pivotal role in promoting protective sexual behaviours. The role of gender and the gaps in LHAP (Life Skills' HIV/AIDS programme) also require urgent attention.
Identification of sources from which doctors in the private sector obtain information on HIV and AIDS.
(MedPharm, 2009) Naidoo, Panjasaram.; Jinabhai, Champaklal Chhaganlal.; Taylor, Myra.
Background: Doctors need to constantly update their knowledge and obtain information in order to practise high-quality medicine. Antiretroviral drugs have been available only since around 1996, therefore many of the doctors who were trained prior to 1996 would not have received any formal training in the management of HIV and AIDS patients. Where doctors source their general medical knowledge has been established, but little is known about where doctors source information on HIV/AIDS. This study investigated where private sector doctors from the eThekwini Metro obtain information on HIV and AIDS for patient management. Methods: A descriptive cross-sectional study among 133 private general practitioners (GPs) and 33 specialist doctors in the eThekwini Metro of KwaZulu-Natal, South Africa, was conducted with the use of questionnaires. The questionnaires were analysed using SPSS version 15. A p value of < 0.05 was considered statistically significant. Results: The majority of the doctors (92.4%) obtained information on HIV and AIDS from journals. Continuing Medical Education (CME), textbooks, pharmaceutical representatives, workshops, colleagues and conferences were identified as other sources of information, while only 35.7% of doctors were found to use the internet for information. GPs and specialists differed significantly with regard to their reliance on colleagues (52.9% versus 72.7%; p < 0.05) and conferences (48.6% versus 78.8%; p < 0.05) as sources of HIV information. More than 90% of doctors reported that CME courses contributed to better management of HIV and AIDS patients. Conclusion: Private sector doctors in the eThekwini Metro obtain information on HIV from reliable sources in order to have up-to-date knowledge on the management of HIV-infected patients.
The influence of helminths on immune responses to HIV.
(2009) Mkhize-Kwitshana, Zilungile Lynette.; Walzl, Gerhard.; Taylor, Myra.
In South Africa, co-infection with HIV and intestinal parasites is a major challenge in disadvantaged communities who live in densely populated under-serviced urban informal settlements. This pilot cross sectional study evaluates the immunological effects of co-infection with Ascaris lumbricoides and Trichuris trichura on the immune response to HIV. The work was a substudy of a prospective double blind, placebo-controlled investigation to test whether regular deworming changes the immune profile of HIV positive individuals with concurrent helminth infection. The substudy has a cross sectional design and presents pilot data that defines immune profiles of HIV-1 positive individuals with and without gastrointestinal helminth (Ascaris lumbricoides and Trichuris trichura) infection. The hypothesis was that concurrent helminth infection adversely affects immune responses against HIV. It was conducted in an area of high helminth endemnicity and limited infrastructural resources. Individuals with known HIV infection were recruited from an HIV Support Group and HIV negative individuals residing in the same area (for demographic matching) were used for comparison. The substudy was to provide pilot data for future larger scale and possible interventional studies. The current work is limited by the cross sectional design, moderate sample size and practical challenges. The profile of lymphocyte phenotypes, viral loads, eosinophils, activation markers, expression of the nuclear proliferation antigen-Ki67 and activation regulator antigen CTLA-4 were analysed using flow cytometry in HIV positive and negative subgroups with or without helminth infection. The type-1, type-2 and inflammatory cytokines were analysed using multiplex cytokine array technology. These were correlated with immune responses to HIV. Non parametric statistics were used to describe differences in the variables between the subgroups. A major finding of the study was the result of the supplementary use of the serological marker, Ascaris lumbricoides-specific IgE in addition to the presence (or absence) of helminth eggs in stools to classify intestinal helminth infection status. Two significant outcomes of this measure were the enhancement of diagnosis of current or recent helminth infection and, more importantly, the distinction of different phenotypes of individuals who displayed different immunological responses to co-infection with HIV and helminths. The different helminth infection phenotypes are defined by stool egg positivity (egg⁺) or negativity (egg⁻) with either high or low Ascaris-specific IgE (IgEhi or IgElo) respectively. The four subgroups, egg⁺IgEhi, egg⁺IgElo, egg⁻IgEhi and egg⁻IgElo showed different interactions with regards to immune response to HIV. It should be noted that no Trichuris specific IgE tests are commercially available but that there is significant antigenic cross-reactivity with Ascaris antigen. The presence of helminth stool eggs and high Ascaris IgE (egg⁺IgEhi) was associated with the following characteristics: reduction in numbers of all lymphocyte populations, frequent eosinophilia, highly activated immune profiles, antigen specific proliferative hyporesponsiveness, impaired type 1 cytokine responses in unstimulated and antigen stimulated cells and increased TNFα levels. In HIV infected individuals, the egg⁺IgEhi helminth infection status was associated with lower but not significant CD4⁺ counts and higher viral loads. A strong negative correlation was observed between viral loads, CD4⁺ and CD8⁺ cells in this subgroup. Subgroups with high IgE (egg⁺IgEhi and egg⁻IgEhi) had elevated Th2 markers with lower CD4⁺ counts and higher viral loads in the HIV⁺ group. The inverse correlation between viral load and CD4⁺ counts found in all the HIV⁺ participants was strongest in these two subgroups. Individuals with parasite eggs in stool and low Ascaris IgE (egg⁺/IgElo) presented a modified Th2 profile. This subgroup had high absolute numbers of all lymphocyte subsets in both HIV⁻ and HIV⁺ groups with higher CD4⁺ counts in the HIV⁻ and lower viral load in the HIV⁺ groups as well as higher interferon gamma, lower IL-4 and higher IL-10. In conclusion, the results suggest that helminth infections may be associated with deleterious effects on the immune responses to HIV in certain groups of susceptible individuals. The underlying reasons for the different stool egg/Ascaris IgE combinations in settings with high exposure to helminthes is currently not clear but genetic predisposition and environmental factors could play a role. Future studies of helminth- HIV co-infection have to ensure adequate definition of helminth infection status by the use of both stool examination and measurement of helminth-specific IgE as the infection phenotype is associated with differential effects on HIV associated immune responses. This may also apply to co-infection with other pathogens, including tuberculosis. The long-term effect of helminth co-infection in HIV positive people was not assessed in this study but requires further studies.
The insights of outsiders : investigating learner perceptions of the mass treatment campaign's communication strategy for Schistosomiasis prevention in Ugu District, South Africa.
(2013) Dlomo, Nqobile Ntokozo.; Dyll, Lauren Eva.; Taylor, Myra.
Schistosomiaisis, commonly referred to as bilharzia is a neglected tropical parasitic water borne disease prevalent in developing countries and is endemic in KwaZulu-Natal, South Africa. The World Health Organisation (WHO) aims to eliminate bilharzia as a public health problem by the year 2020 and as a measure to work towards this goal, the South African Department of Health (DoH) Ugu District, KwaZulu-Natal commenced a Mass Treatment Campaign (MTC) targeted at rural schools to decrease bilharzia infection intensity and prevalence levels. The DOH MTC utilises communication materials to communicate with stakeholders and the public to create awareness of the campaign and bilharzia. This study specifically explored the perceptions of learners towards the communication materials used by the DOH MTC to communicate with the learners in order to generate improvements for the current communication strategy. The ability of an individual to receive information is commonly impacted by the community, social networks and the environment and infrastructural settings of the community. The Social Ecological Model of Communication and Health Behaviour (SEMCHB) acknowledges that such factors may have an impact on how the individual receives information. The study utilises the broader social ecological perspective, and particularly the SEMCHB as a framework for understanding and exploring the perceptions of learners. The study made use qualitative data through focus group discussions, semi- structured interviews and participant observations to gain insights from learners. The study discovered that many incorrect perceptions about bilharzia still surround the learners. The perceived messages communicated through the DoH MTC still need to be communicated with learners, since some learners face challenges in understanding the preferred message. The encoding of the communicated messages through the poster, pamphlet and consent forms is influenced by the individuals social networks hence this study recommends that future communication message are designed with reference to the SEMCHB.
Intimate partner violence against women living with and without HIV: contexts and associated factors in Wolaita Zone, Ethiopia.
(2021) Koyira, Mengistu Meskele.; Khuzwayo, Nelisiwe.; Taylor, Myra.
Background: Intimate partner violence (IPV) and Human Immunodeficiency Virus (HIV) are overlapping or intersecting public health challenges. Intimate partner violence is considered to be strongly related to HIV infection among women in Africa. However, the evidence is not conclusive. Women who are abused physically by their partners seek medical treatment in public institutions, yet, in Ethiopia, the experience of healthcare workers (HCWs) in screening IPV among HIV-positive and HIV-negative clients is not fully understood Purpose: This study aimed to map the evidence of IPV in Sub-Saharan Africa, to measure the factors associated with IPV, to explore the experience of IPV against women living with and without HIV, and the health care workers' IPV screening experience in Wolaita Zone, southern Ethiopia. Objectives 1. To conduct a scoping review of IPV among women living with HIV/AIDS in Sub- Saharan Africa. 2. To explore the lived experience of IPV against women using antiretroviral therapy (ART) and other outpatient services in Wolaita Zone. 3. To explore the experiences and challenges in screening for IPV among women who use ART and other health services in Wolaita Zone. 4. To measure the prevalence and associated factors of IPV among women living with and without HIV in Wolaita Zone. Methods: This is a mixed-methods study. I conducted both qualitative and quantitative studies.. Initially, I mapped the evidence of IPV among HIV-positive women in Sub-Saharan Africa using a scoping review. Then, I conducted an exploratory sequential design of mixed-methods research. An interpretative (hermeneutic) phenomenological design was used to explore the lived experiences of women who were living with and without HIV. Additionally, I used a descriptive phenomenological study design to explore the IPV screening experiences of 16 HCWs. I also used a comparative cross-sectional study comprising 816 women between 18-49 years who were living with and without HIV for the quantitative study. I used the standard questionnaire of the World Health Organization (WHO) multi-country study on women's health and domestic violence against women (translated). The scientific rigour, dependability, and credibility relating to this sensitive subject were maintained. I used STATA software, version 15 for the quantitative data analysis; NVIVO 12 assisted us in developing a framework, and Colaizzi's analysis for the qualitative data. I used the binary and multivariable logistic regression model for the quantitative analysis. Results: The scoping review provided a summary of the evidence of IPV experiences among women with HIV/AIDS. As this review has shown, the HIV-positive women were at considerable risk of IPV after disclosure of their serostatus to a male partner. Psychological and emotional abuse was the most common form of violence reported by the review. Subsequently, in the quantitative study, we found a high lifetime prevalence of IPV among all women in Wolaita Zone, 487 (59.68%, [95% CI:56.31%-63.05%]. It was slightly higher among women living with HIV, 250 (61.3%), than among those who were HIV negative, 238 (58.09%). Factors associated with IPV were the controlling behaviour of husband/partner [AOR=8.13; 95% CI: 4.93-13.42], poor wealth index [AOR=3.97; 95% CI:1.81-8.72], bride price payment to bride‘s family[AOR=3.46; 95% CI:1.74-6.87], women‘s decision to refuse sex [AOR=2.99;95% CI:1.39-6.41], age group of women [AOR=2.86; 95% CI:1.67-4.90], partner‘s family choosing a wife [AOR=2.83; 95% CI:1.70-4.69], alcohol consumption by partner [AOR=2.36; 95% CI:1.36-4.10], number of sexual partners [AOR=2.35; 95% CI:1.36-4.09], and if a partner ever physically fought with another man [AOR=1.83; 95% CI: 1.05-3.19]. Inappropriate legal punishment of the perpetrator and the lack of a supportive women's network to avert IPV were perceived as limitations by the women. There were HCW and health system-related challenges in screening for IPV. These challenges comprised a gap in the medico-legal report provision, absence of separate record-keeping for IPV cases, lack of client follow-up, and lack of coordination with an external organisation. Conclusions and recommendations: There was a high prevalence of IPV among women, both living with and without HIV. The extent of IPV and its presentation in the different forms (physical, sexual and psychological), which frequently overlapped, highlights the urgency of intervention measures. Women reported terrifying experiences of violence, which affected their health physically, mentally, and psychologically. There are also challenges concerning HCWs, health systems, and the clients, relating to screening for IPV. Scoping review revealed evidence of IPV experience among women with HIV/AIDS, evidence of how HIV status disclosure influences IPV, and proof of the association of socio-demographic characteristics with IPV. It was concluded that marriage arrangements should be by mutual consent of the marriage partners rather than being made by parents; it is advisable to involve males in all programmes of genderbased violence prevention to change their violent behaviours; there is a need for the arrangement of separate record-keeping of IPV cases at the health facilities and for standardising the medico-legal reporting system. Finally, this study emphasises the importance of executing more gender-equitable policies.
Investigating the implementation of malnutrition guidelines in children aged between 6 months and 59 months at primary health care clinics in eThekwini health district, KwaZulu Natal, South Africa.
(2022) Grootboom, Busi.; Taylor, Myra.
Abstract available in a PDF
Investigating the influences on sexual abstinent behaviour of rural African high school going youth in KwaZulu-Natal.
(2007) Dlamini, Siyabonga Blessing.; Taylor, Myra.
Introduction: The high prevalence of HIV in South Africa was confirmed by Department of Health (2005) which reported an HIV prevalence rate of 40.7 percent amongst antenatal clinic attendees at public facilities in KwaZulu-Natal in 2004. Abstinence is one of the strategies used by many different cultures where young unmarried people are encouraged to abstain from sex until marriage, to prevent young girls from getting pregnant and acquiring sexually transmitted infections (STIs). Aim: The aim of this study was to investigate African rural high school learners' choice of sexual abstinence and to compare abstinent versus non-abstinent African rural high school learners in order to be able to develop tailored educational messages. Abstinence was defined as not having penetrative sex, since this is the accepted definition of abstinence in Zulu culture. Objectives: a) To investigate the prevalence of abstinence from sexual intercourse amongst African rural high school learners, b) To assess demographic, psychosocial, and economic determinants of abstinence from sexual intercourse, c) To make recommendations about abstinence interventions. Method: A descriptive cross-sectional study was carried out in a rural area (Ugu District in southern KwaZulu-Natal). One class of Grade 9 learners, ages 14-20 years, was selected from each often randomly selected rural high schools. An anonymous selfreporting semi-structured questionnaire used the I-Change model to investigate demographic and economic information, attitudes, social influences, self-efficacy and intentions towards sexual abstinence. Chi square and T-tests were used for bivariate analysis and Logistic regression was used to develop a model for abstinence from sexual intercourse. Results: A total of 454 learners participated with a mean age of 16.76 years (SD 1.41) age range 14-20 years. Of the sample 208 (45.8%) were male and 246 (54.2%) female. The majority were Christian (84.6% (n=384)) and of this population, 28.3% (n=127) reported that they had 'ever had sex'. Furthermore, 24.5% (n=91) of learners reported that they were currently sexually active. Fifty six percent (n=252) of learners reported that they abstained from sex. When comparing learners reporting abstinence (n= 252) with those not abstinent (n= 202), abstinent learners were significantly more often females, who had never had sex (p
M-PH : knowledge, beliefs and attitudes regarding counselling behaviour for HIV and AIDS, STIs and TB : a survey of eThekwini district primary health care workers.
(2012) Ntlangula, Margaret N.; Taylor, Myra.
Background HIV infection continues to be a challenge in South Africa with new infections reported at alarming rates. Health Care Workers (HCWs) who are nurses consequently have frequent contact with HIV positive and TB co-infected patients. During this contact their counselling behaviour is influenced by their knowledge, beliefs and attitudes about HIV and AIDS, STIs and TB (HAST) and may influence provision as well as the quality of HAST counselling behaviour. Aim The aim of the study was to assess eThekwini Municipality Health Care Workers’ knowledge, beliefs and attitudes regarding counselling behaviour for HAST and to make recommendations based on the findings of this study. Methods A descriptive cross sectional study design was used in which data about HAST counselling behaviour were collected using self administered questionnaires. The study population was all the nurses working at eThekwini Municipality Health clinics that were on duty at the time of the study and excluded those nurses who were absent or on leave during the period of data collection. Informed consent was signed by each respondent. Data were captured using SPSS version 14 and univariate, bivariate and multivariate analysis was undertaken. The level of significance was P<0, 05. Results The HCWs were well informed regarding counselling behaviour for HAST. HCWs with university education scored higher than those with college level of education but there were no statistically significant differences between the HCWs with the university education and those with college education. However some HCWs’ attitudes and beliefs about poverty were negative and may not be helpful in improving a patient’s health. Results showed that some HCWs’ negative attitudes about HAST counselling resulted from fear of HIV and or TB infection. Age and the level of education showed statistically significant association with beliefs. Older, better educated HCWs with a university education scored higher for knowledge for HAST counselling behaviour. There was no statistical significant difference found between HCWs who see less than 100 patients per day and those who see more than 100 patients per day. Conclusion The findings of the study show that HCWs were well informed regarding counselling behaviour for HAST, even though some HCWs have negative attitudes which are not supportive which need to be addressed. Recommendations It is recommended that HCWs receive continuous training in order to address the negative attitudes about counselling behaviour for HAST.
Paternal roles in promoting child well-being: what are the challenges facing paternal involvement in child healthcare in rural South Coast Kenya?
(2015) Songola, Kennedy Munyambu.; Taylor, Myra.
Introduction While it has long been accepted that mothers play a key role in child health outcomes, the role of the father is less well understood. The proposed study was nested in another study investigating the relationship between the social environment and child health, growth and development. The work took place in South Coast Kenya, Kwale County, an area characterized by low income, restricted health resources, and exposure to multiple infections, including malaria. Child health clinics are largely contained within Mother and Child Health programmes [1, 2]. This has excluded the fathers who rarely visit the health facilities. This observation made during previous studies in the area was a clear indication of little paternal involvement with their children. Through previous studies carried out in this region, community consultation groups have consistently made recommendations on how to improve the existing situation[2]. It clearly emerged that other family members, particularly fathers, need to be included in the process of addressing child health and development. Therefore, this study aimed to investigate how paternal involvement in child health services can affect child wellbeing in collectivist rural communities in South Coast Kenya. It has also highlighted their attitudes and beliefs towards parenting and how they affect child health outcomes. Objectives This study had three main objectives to investigate parenting in a rural low income setting. They included describing and comparing the maternal and paternal attitudes and perceived parenting roles and responsibilities in managing infant health, investigation of the relationship between parental psychosocial factors and child health outcomes in the two main communities (Mijikenda vs. Non-Mijikenda communities) within the study area and finally, to summarize the key factors affecting paternal inclusion or involvement in child health programmes. Methodology Two types of interviews were administered to both parents (fathers and mothers) to find out their roles, attitudes and beliefs towards parenting. The first type of interview used was a quantitative structured interview and it investigated their parenting stress. The second was a qualitative semi-structured in-depth interview and investigated the parents’ roles, beliefs, and attitudes towards parenting. Data analysis was carried out using SPSS21 Software for quantitative data and NVivo10 Software for qualitative data. The information has been used to explain the existing pattern of parental involvement in child health care programmes. Study findings The results suggested that both mothers and fathers were very happy to be parents and were willing to be involved with their child or children in promoting their well-being. Nevertheless, although the mothers agreed with the fathers’ reports that they were practically involved in supporting their children financially, decision making and providing their daily needs, they disagreed with paternal reports that fathers participated in taking their children to the hospital when sick. None of the parental characteristics was significantly associated with the child health variables measured. The extra challenges parents experience in parenting and their inability to handle their children well were associated with poor parenting styles. Their low household income and health care system factors preventing working fathers from attending clinic were also associated with low paternal involvement with their children and in the management of their children’s health. Conclusion Financial constraints and the design of the healthcare system, biased in favour of the mothers are major obstacles affecting paternal involvement with their children. The fathers in the study area are willing to take part in any activity undertaken to promote the well-being of their children and generally happy to be parents. Increased paternal involvement in the healthcare programmes may improve the wellbeing of their children and the public at large.
Perceptions of undergraduate students of University of KwaZulu-Natal regarding HIV counselling and testing in the year 2012.
(2013) Venugopala, Rashmi.; Taylor, Myra.
South Africa has one of the highest prevalence of HIV infections in the world. Sexual transmission is the primary mode of transmission across the country’s population. Misinformation about AIDS, negative attitudes to HIV testing and AIDS’ stigmatizing beliefs represent potential barriers to seeking HIV testing. Youth between 15-24 years have the greatest risk of HIV infection but only 37% of students at the University of KwaZulu-Natal (UKZN) had undertaken HIV counselling and testing (HCT) according to the HEAIDS (2008) report. Prevention of HIV and behaviour change includes knowledge about, and adequacy of, HIV counselling and testing (HCT) resources on campuses. The aim of this study was to investigate students’ perceptions about HCT at UKZN and make recommendations regarding improvements. An observational, analytical, cross-sectional study of UKZN undergraduate students on the five campuses was conducted. Participants completed anonymous self-administered questionnaires. Of 965 surveyed students, 663 (71%) had tested for HIV among whom 545 (58%) were females and 501(52%) were 20-25 years. Fear of positive results, perceived low risk of acquiring the infection and having confidence in his/her partner influenced student HIV testing behaviour (p<0.001). A significant difference was also found in positive attitudes towards HCT on campus between people who had tested (median score 20) and people who had not tested (median score 18) (p < 0.05). Since one third of students at UKZN had not tested for HIV, HCT at UKZN needs to be advertised more effectively so as to increase HIV testing by students on campuses.
Prevalence and intensity of Schistosoma haematobium in KwaZulu-Natal, South Africa.
(2016) Banhela, Nkosinathi.; Taylor, Myra.
Background and objectives: Urogenital schistosomiasis is a neglected tropical disease caused by the parasite Schistosoma haematobium, which is receiving increased attention, due to its reported association with diseases such as the Human Immunodeficiency Virus, genital cancers, sexually transmitted diseases and liver diseases. Symptoms of urogenital schistosomiasis include haematuria, frequent urination, tiredness and a decrease in the cognitive ability of children. The prevalence of S. haematobium infection needs to be known and mass treatment programmes against the disease implemented. The aim of this study was to investigate the prevalence and intensity of S. haematobium infection. The objectives were to determine the prevalence and intensity of S. haematobium among school going children in ILembe and uThungulu Health Districts of KwaZulu-Natal province, to determine if there is an association between school location, sex, altitude, temperature and the prevalence of schistosomiasis and to assess the need for mass treatment campaigns. Methods: In this study, 6265urine samples were collected for analysis using dipsticks from boys and girls attending rural public schools in these health districts. The prevalence and intensity of S. haematobium infection was calculated and thereafter associations with temperature, altitude and distance to the nearest river were investigated. Descriptive and analytical statistics were undertaken, the latter using a correlation coefficient and a linear regression (p˂0.05) (Confidence Interval (CI) 95%). Results: The prevalence of schistosomiasis for boys in ILembe was 40% and girls 39% and in uThungulu was 56% and 53% in girls and boys respectively. Most infection was the dominant intensity in both the Districts. There was a significant inverse relationship between prevalence of schistosomiasis and altitude (p˂0.05). Associations between prevalence and distance of school to the nearest river were non-significant, and the average minimum summer temperature also showed a positive relationship but that was non-significant (p˃0.05). Conclusion: In both the Districts, the prevalence fell in the category that is recommended by the World Health Organisation for mass treatment. This information alerts health care workers to take the necessary actions to combat schistosomiasis infection and the transmission of urogenital schistosomiasis by providing mass treatment with praziquantel. Mass treatment in endemic communities impacted by schistosomiasis can significantly reduce the morbidity caused by the disease. Furthermore, treatment at an early age can help avoid complications that would predispose individuals to the risk of HIV. In endemic areas, public education about the disease should be prioritized. Furthermore clean water sources should be provided for communities at risk to prevent reinfection