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

{"title":"Unimpaired vision is an indispensable prerequisite for safe driving.","authors":"Josef Finsterer","doi":"10.4102/phcfm.v16i1.4810","DOIUrl":"10.4102/phcfm.v16i1.4810","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e2"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life orientation teachers' perspectives on intersectoral collaboration management of sexuality education.","authors":"Zoe Pillay, Faniswa H Mfidi","doi":"10.4102/phcfm.v16i1.4703","DOIUrl":"10.4102/phcfm.v16i1.4703","url":null,"abstract":"<p><strong>Background: </strong> According to the United Nations Fund for Population Activities, sexuality education (SE) requires building a multisectoral team and developing an operational plan. Hence, teaching comprehensive sexuality education (CSE) in collaboration with relevant stakeholders is a managerial approach to provide school-going adolescents with the knowledge and skills to make informed decisions that will safeguard their health.</p><p><strong>Aim: </strong> To report on Life Orientation (LO) teachers' perspectives on intersectoral collaboration management of SE in secondary schools in KwaZulu-Natal (KZN) province, South Africa.</p><p><strong>Setting: </strong> Four selected secondary schools in the sub-district of uMhlathuze, KZN.</p><p><strong>Methods: </strong> The study employed a qualitative design. The population of this study comprised of 16 LO teachers who were selected by means of homogeneous sampling through focus group discussions. Emerging patterns were observed once the data were transcribed and subjected to thematic analysis.</p><p><strong>Results: </strong> The study revealed that schools were not being supported in the management of intersectoral collaboration in SE implementation in secondary schools in KZN province, South Africa.</p><p><strong>Conclusion: </strong> The results made it evident that more needs to be done to enhance and fortify intersectoral collaboration management to strengthen CSE in secondary schools.Contribution: The study recommended innovative and improved SE programmes and projects throughout the implementation and evaluation process to identify successes and promptly correct errors, to guarantee appropriate coordination of intersectoral collaboration management.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e7"},"PeriodicalIF":1.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary lipoarabinomannan for diagnosis of Tuberculosis in an HIV-negative population: A scoping review.","authors":"Omishka Hirachund, Somasundram Pillay","doi":"10.4102/phcfm.v16i1.4733","DOIUrl":"https://doi.org/10.4102/phcfm.v16i1.4733","url":null,"abstract":"<p><strong>Background: </strong> Tuberculosis (TB) remains a leading cause of mortality in low-resource settings and poses a diagnostic challenge in human immunodeficiency virus (HIV)-negative populations because of limitations in traditional diagnostic methods such as sputum smear microscopy (SSM) and sputum Xpert Ultra. There is a lack of effective, non-invasive diagnostic options for TB diagnosis in HIV-negative populations. This scoping review explores the potential of urinary lipoarabinomannan (ULAM) as a point-of-care diagnostic tool for Mycobacterium tuberculosis (MTB) in HIV-negative individuals.</p><p><strong>Aim: </strong> To evaluate the diagnostic performance of ULAM in detecting TB among HIV-negative populations and assess its feasibility as a rapid, non-invasive diagnostic method.</p><p><strong>Method: </strong> A systematic search was conducted across PubMed, Google Scholar and Scopus. Articles were selected based on relevance to the topic.</p><p><strong>Results: </strong> The search yielded 210 articles, with 11 meeting our inclusion criteria. These studies reported varying diagnostic performance metrics for ULAM: sensitivity ranged from 10.0% to 66.7% and specificity from 90.0% to 98.1% among different assays. Notably, the studies demonstrated that the novel assays such as Electrochemiluminescence LAM and the second-generation FujiLAM showed higher sensitivities of 66.7% and 53.2%, respectively. Despite these advancements, the overall effectiveness of ULAM in HIV-negative populations remains limited, with standard assays exhibiting sensitivities as low as 10.0%.</p><p><strong>Conclusion: </strong> While ULAM holds potential as a diagnostic tool in HIV-associated TB, its application in HIV-negative populations is constrained by low sensitivity of the currently available assays.Contribution: The development and validation of high-sensitivity assays are crucial for broadening the utility of ULAM in these populations.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home visits for preterm/low birthweight infants in South Africa: Qualitative evidence synthesis.","authors":"Sara Cooper, Idriss I Kallon, Denny Mabetha, Amanda S Brand, Tamara Kredo, Shakti Pillay, Gugu Kali, Willem Odendaal","doi":"10.4102/phcfm.v16i1.4701","DOIUrl":"10.4102/phcfm.v16i1.4701","url":null,"abstract":"<p><strong>Background: </strong>Prematurity and low birth weight (LBW) are the main causes of neonatal mortality in South Africa (SA). Home visits by lay health workers (LHWs) may be effective in addressing this.</p><p><strong>Aim: </strong>To inform a national guideline on LHW home visits as part of the Global Evidence, Local Adaptation (GELA) project, we conducted a rapid qualitative evidence synthesis exploring the acceptability, feasibility and equitability of this intervention for preterm and LBW babies.</p><p><strong>Setting: </strong>We included studies conducted in SA.</p><p><strong>Methods: </strong>We searched PubMed and Embase until 15 September 2023 and identified eligible studies independently and in duplicate. We synthesised evidence using thematic analysis, assessed study quality using an adaptation of the Critical Appraisal Skills Programme tool and assessed confidence in the review findings using GRADE-CERQual.</p><p><strong>Results: </strong>The 16 eligible studies included diverse settings and populations in SA. Factors facilitating mothers' acceptance included the knowledge and skills gained, the psychosocial support offered and improved healthcare access and relationships with facility staff. Distrust in LHWs and stigma associated with home visits were barriers to acceptance. Lay health workers' acceptance was facilitated by them feeling empowered. The emotional burden of home visits for LHWs, coupled with insufficient training and support, undermined the feasibility of home visits.</p><p><strong>Conclusion: </strong>A complex range of interacting contextual factors may impact on the implementation of home visit programmes for preterm and LBW infants in SA.</p><p><strong>Contribution: </strong>This country profile provides insights into how home visits for preterm and LBW infants in SA might be contextually tailored to increase local relevance and in turn effectiveness, with potential relevance for other African countries.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next steps for the East, Central and Southern Africa College of Family Physicians (ECSA-CFP).","authors":"Innocent K Besigye, Mpundu Makasa, Martha Makwero, Jacob S Shabani, Sunanda Ray","doi":"10.4102/phcfm.v16i1.4753","DOIUrl":"10.4102/phcfm.v16i1.4753","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e2"},"PeriodicalIF":1.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of common mental disorders in people living with HIV in primary health care facilities in Ekurhuleni district.","authors":"Aniekan Edet, Samuel Agbo, Afolake A Amodu, Nwabisa N Edet","doi":"10.4102/phcfm.v16i1.4568","DOIUrl":"10.4102/phcfm.v16i1.4568","url":null,"abstract":"<p><strong>Background: </strong> There is paucity of data regarding the prevalence of common mental disorders (CMDs) in people living with HIV (PLHIV) in Ekurhuleni Health District (EHD), South Africa. Also, there is an association between CMDs and poor HIV treatment outcomes. Guidelines therefore recommend that healthcare practitioners screen for CMDs in PLHIV.</p><p><strong>Aim: </strong> To determine the prevalence and correlates of CMDs in PLHIV in primary health care facilities in Ekurhuleni district.</p><p><strong>Setting: </strong> Seven primary health facilities in Ekurhuleni district.</p><p><strong>Methods: </strong> A cross-sectional study was conducted in which data were collected from 403 randomly selected participants, using a questionnaire that incorporated the scores of the Patient Health Questionnaire (PHQ)-9, generalised anxiety disorder (GAD)-7 and substance use disorder (SUD) criteria of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5). The proportion screening positive for CMDs was calculated. 'R' statistical software was used for univariate and multivariate analysis, with a confidence interval (CI) of 95%.</p><p><strong>Results: </strong> Most participants (63%) were female and the mean age was 43 ± 11 years. Forty per cent of participants screened positive for CMDs, 16.6%, 15.1% and 24.1% screened positive for depression, GAD and SUD, respectively. Common mental disorders were associated with poor adherence and HIV non-suppression, while increasing age and being female were associated with reduced risk of CMDs. The risk of severe SUDs in males was 11 times compared to females. During assessment, clinicians screened only 16%, 14% and 40% of the cohort for depression, GAD and SUDs, respectively.</p><p><strong>Conclusion: </strong> The prevalence of CMDs remains high. Adherence to recommendations to screen for CMDs in PLHIV is low.Contribution: This study reveals a low CMD screening rate, estimates the prevalence of CMDs in PLHIV in Ekurhuleni district, and its impact.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e11"},"PeriodicalIF":1.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of roles of community healthcare workers in early childhood in Limpopo, South Africa.","authors":"Aneesa Moolla, Lezanie Coetzee, Constance Mongwenyana, Anne Robertson, Gert Marincowitz, Michele Zuckerman, Fink Günther, Davidson H Hamer, Aisha Yousafzai, Peter C Rockers, Denise Evans","doi":"10.4102/phcfm.v16i1.4412","DOIUrl":"10.4102/phcfm.v16i1.4412","url":null,"abstract":"<p><strong>Background: </strong> As part of the Reengineering Primary Health Care initiative, the South African National Department of Health (NDoH) has committed to expanding access to home-based care provided by community health workers. The NDOH also prioritised Community Health Workers (CHWs) in their agenda to improve child development outcomes in South Africa. However, there is limited research on CHWs' experiences and knowledge of early childhood development.</p><p><strong>Aim: </strong> To explore CHWs' motivation for work, their background, training and scope of work around Early Child Development (ECD).</p><p><strong>Setting: </strong> The study was conducted in Mopani District, Limpopo province, South Africa, in 2017.</p><p><strong>Methods: </strong> Five focus group discussions (FGDs) were conducted with 41 CHWs participating within a large cluster-randomised study. Data were analysed thematically using an inductive approach.</p><p><strong>Results: </strong> Community health workers' motivation to work was influenced by personal experiences, community needs and community service. In terms of knowledge, CHWs indicated that a nutritious diet with extended breastfeeding, immunisations and preschool education is imperative for a child to thrive. The Road to Health Booklet, weighing scales and the mid-upper arm circumference tape were used as screening tools for ECD. Community health workers perceived their knowledge around ECD to be insufficient.</p><p><strong>Conclusion: </strong> Community health workers play a crucial role in healthcare; therefore, capacity development on ECD and the provision of ECD screening tools to optimise their under-five child visits are necessary.Contribution: This study will potentially contribute to the improvement of the CHW programme in ensuring that children under 5 years of age are holistically cared for to ensure that they thrive.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e10"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses and policymakers role in preparing adolescents with HIV for self-disclosure in Eswatini.","authors":"Baliwe P Dlamini, Ntombifikile G Mtshali","doi":"10.4102/phcfm.v16i1.4332","DOIUrl":"10.4102/phcfm.v16i1.4332","url":null,"abstract":"<p><strong>Background: </strong> Nurses in Eswatini are best positioned to assist adolescents living with HIV to disclose their status to others. Nonetheless, it is evident that many nurses are not actively involved in the disclosure process.</p><p><strong>Aim: </strong> The aim of this study was to explore the process of nurses in preparing adolescents for self-disclosure and describe the role of policymakers in enabling adolescents to disclose their HIV status to others.</p><p><strong>Setting: </strong> The study was conducted in four facilities, one from each of the four regions of the country, after getting ethical clearance from a Public University Higher Degrees Ethics Committee and the Eswatini Health and Human Research Review Board.</p><p><strong>Methods: </strong> In-depth interviews were conducted on 28 participants: 24 nurses and 4 policymakers. The three steps of open, axial and selective coding were used to analyse data until theoretical saturation was achieved.</p><p><strong>Results: </strong> Adolescents were assisted to disclose by providing them with HIV information to empower them, encouraged to enrol in teen club because it created a conducive environment for peer-to-peer support, and they were given ongoing psychosocial support to prepare them for self-disclosure. Adolescent HIV management workshops were not routinely done because such training relied on funders.</p><p><strong>Conclusion: </strong> Nurses are not preparing adolescents satisfactorily to disclose. Prioritising the training of nurses would lead to a remarkable increase in the rate of HIV self-disclosure by Swati adolescents.Contribution: This study is the first of its kind in Eswatini, and the results will contribute to the review of HIV management guidelines and promote adolescent self-disclosure.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ideal Clinic Realisation and Maintenance programme implementation in rural KwaZulu-Natal.","authors":"Donald T Mhlungu, Geertien C Boersema, Mokholelana M Ramukumba","doi":"10.4102/phcfm.v16i1.4586","DOIUrl":"10.4102/phcfm.v16i1.4586","url":null,"abstract":"<p><strong>Background: </strong> The delivery of quality primary healthcare (PHC) services is vital for enhancing the health status of rural communities, yet persistent barriers exist in resource-constrained rural settings.</p><p><strong>Aim: </strong> The study explored perspectives on the barriers to and facilitators of implementing the Ideal Clinic Realisation and Maintenance (ICRM) programme as a quality assurance initiative in a rural KwaZulu-Natal subdistrict.</p><p><strong>Setting: </strong> Professional nurses and healthcare managers from seven PHC clinics in a rural subdistrict of KwaZulu-Natal and supervising managers from a district hospital participated in this study.</p><p><strong>Methods: </strong> Telephonic semi-structured interviews were conducted using a qualitative case study approach with the purposively selected sample. Data were inductively and thematically analysed.</p><p><strong>Results: </strong> Themes included ICRM programme organisation, barriers and facilitators for implementing the ICRM programme. Barriers in rural PHC settings included overburdened clinics, suboptimal infrastructure, staff burnout, poor communication and non-adherence to clinical guidelines. Despite obstacles, programme implementation was facilitated through stakeholder support and teamwork. Participants emphasised the need for infrastructure upgrades, more human and physical resources, and maintenance of stakeholder support.</p><p><strong>Conclusion: </strong> If challenges are mitigated and supportive factors are leveraged, the potential for successful programme implementation and improved healthcare delivery can benefit both healthcare providers and recipients.Contribution: Through providing insight into the perspectives of both implementers and supervisors, the study informs stakeholders and policymakers about difficulties encountered and potential improvements to be made in the implementation of the ICRM programme in rural PHC.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body composition estimates from bioelectrical impedance and its association with cardiovascular risk.","authors":"Jesne Kistan, Jeffrey Wing, Khanyisile Tshabalala, Wesley Van Hougenhouck-Tulleken, Debashis Basu","doi":"10.4102/phcfm.v16i1.4587","DOIUrl":"10.4102/phcfm.v16i1.4587","url":null,"abstract":"<p><strong>Background: </strong> Screening for traditional risk factors of cardiovascular disease is well known in primary healthcare (PHC) settings. However, other risk factors through newer tools (such as bioelectrical impedance analysis [BIA]) could also be predictors of increased cardiovascular risk (CVR). Body composition estimates (body fat percentage, body water percentage, body lean mass) by BIA and its association to CVR have been studied with variable results.</p><p><strong>Aim: </strong> This study assesses the body composition estimates and their association with CVR in the South African PHC setting.</p><p><strong>Methods: </strong> A retrospective record analysis was conducted on a cohort of de-identified patients utilising the ABBY® Health Check Machine at a PHC facility in South Africa between May 2020 and August 2022. The ABBY Machine estimates body fat percentage (BF%) and body water percentage (BW%) estimates from BIA. Cardiovascular risk based on the Framingham-risk-score was stratified into high, medium and low CVR. An analysis of variance was used to determine mean differences of BF% and BW% among these groups.</p><p><strong>Results: </strong> A total of 4008 records (n = 4008) were used in the final analysis. The majority of patients were female (70.1%) with a mean age of 33.6 years. Higher mean BF% (35.75% vs. 31.10% vs. 27.73%; p  0.0001) and lower mean BW% (49.46% vs. 53.15% vs. 56.18%; p = 0000) were found to be significantly associated with high CVR.</p><p><strong>Lessons learnt: </strong> This study demonstrated the use of newer technologies that could assist in the identification of CVR in low resource PHC settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}