Student's Journal of Health Research Africa
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A Prospective analysis of self-guided home rehabilitation following rotator cuff repair - A cohort study.
Get PDFBackground
Rotator cuff injuries are common in older adults and can significantly affect shoulder function and quality of life. While surgical repair is the primary treatment, postoperative rehabilitation plays a critical role in functional recovery. This study aims to evaluate the clinical and functional outcomes of mini-open rotator cuff repair (RCR) surgery with a home-based rehabilitation protocol.
Methods
This prospective observational study was conducted over two years at two tertiary care centers. A total of 90 patients who underwent RCR surgery were evaluated using clinical assessments, radiographs, and MRI. Postoperative outcomes were measured up to one-year follow-up, including pain, functional recovery, and range of motion.
Results
The majority of participants were middle-aged males (mean age 54.6 years; 71.1% male), with a predominance of right-hand dominance and involvement of the dominant arm in 70% of cases. Manual laborers comprised nearly two-thirds of the cohort, indicating high physical demand among the affected population. Significant improvements were observed in pain (VAS score reduced from 7.6 to 1.4) and functional outcomes (DASH score improved from 34.1 to 4.3). Range of motion also showed considerable improvement, with active abduction increasing from 97° to 135°. Treatment failures occurred in 4.4% of patients, and 91% returned to full work within three months post-surgery.
Conclusion
Mini-open RCR with home-based rehabilitation results in significant functional recovery and low complication rates in most patients.
Recommendation
Further studies should focus on patient selection criteria to optimize outcomes, particularly in those with large or retracted tears
From #feesmustfall to #futuresmustrise: The evolution of student activism and policy change at Mangosuthu University of Technology. A qualitative case study.
Get PDFBackgroundStudent activism has been a pivotal force in shaping higher education in South Africa. At Mangosuthu University of Technology (MUT), the #FeesMustFall movement (2015–2017) spurred demands for free education, decolonized curricula, and institutional reform. While immediate outcomes of the protests are well documented, limited attention has been paid to the long-term evolution of activism into structured policy engagement during the emerging “FuturesMustRise” era.
Methods
This qualitative case study was conducted at MUT between January 2024 and April 2025. Data were collected through semi-structured interviews with 15 former and current student leaders active from 2015 to 2025, and 5 university administrators involved in governance and transformation. In addition, 20 institutional documents, including protest memoranda, council minutes, policy revisions, and transformation reports, were analysed. Braun and Clarke’s thematic analysis framework was applied to ensure triangulation and depth.
Results
Findings revealed a post-2018 shift from protest to structured activism, with 80% of student leaders participating in governance structures such as the Transformation Committee and SRC Policy Forums. Administrators (60%) acknowledged activism’s influence on reforms in financial aid and student accommodation. However, only 27% of participants (both students and administrators) viewed curriculum decolonization efforts as meaningful, with the majority describing such initiatives as symbolic or superficial. A decline in sustained activism following partial victories was also noted, risking stagnation of deeper reforms.
Conclusion
Student activism at MUT has transitioned into formal governance engagement, resulting in incremental but meaningful policy change. Yet, challenges remain in achieving comprehensive transformation, particularly in decolonizing the curriculum.
Recommendations
MUT should institutionalize student advisory structures with decision-making authority, implement leadership development initiatives, and create transparent systems for tracking reforms. Above all, curriculum decolonization must be prioritized beyond symbolism to achieve long-term institutional change
Post-COVID policy shifts in higher education: A mixed-methods cross-sectional case study on rhetoric vs. Reality in digital transformation efforts.
Get PDFBackgroundThe COVID-19 pandemic accelerated digital transformation in higher education globally. In South Africa, universities swiftly adopted policies promoting inclusive, technology-driven teaching and learning. However, despite these policy shifts, a significant gap remains between institutional rhetoric and practical implementation. Digital inequality, insufficient staff training, and infrastructure limitations continue to hinder meaningful and sustainable transformation.
MethodsA mixed-methods cross-sectional case study was conducted across three South African universities. Quantitative data were collected through an online survey administered to 150 academic staff, with 132 valid responses analysed using descriptive statistics and cross-tabulations. Qualitative data were gathered through 12 in-depth interviews with policymakers, IT staff, and academic personnel. Thematic analysis was used to interpret qualitative findings and triangulate them with survey data.
ResultsSurvey data revealed that 82% of institutions had adopted digital transformation policies, yet only 46% of staff reported receiving sufficient training to implement them effectively. Additionally, 61% identified student internet access as a persistent barrier. Respondents were 58% female and 42% male, with most being academic staff (64%). Interview insights from 18 participants across seven public universities highlighted a disconnect between top-down narratives of smooth digital adaptation and ground-level experiences of uncoordinated rollouts, infrastructure deficits, and resistance to change. Temporary innovations, such as hybrid classrooms and data subsidies, were inconsistently applied and lacked long-term support.
ConclusionPost-COVID digital policies in South African higher education remain ambitious but fragmented. Despite progress, implementation continues to be undermined by systemic and operational challenges. True digital transformation requires more than policy declarations—it demands cohesive leadership, cultural change, and sustainable resource allocation.
RecommendationsUniversities should invest in long-term digital infrastructure, ongoing staff development, and equitable student support. Institutional accountability mechanisms must be embedded to monitor implementation. A multi-stakeholder, collaborative approach is essential to bridging the gap between policy and practice in the digital age
Comparative study of traditional versus digital anatomy teaching using virtual dissection tools: A quasi-experimental study.
Get PDFBackground: Anatomy forms the cornerstone of medical education. While cadaveric dissection has long been the standard method for anatomy teaching, the emergence of digital platforms offering virtual dissection tools has introduced new opportunities for interactive and remote learning—especially during the COVID-19 pandemic.
Objective: To compare the effectiveness of traditional cadaveric dissection and digital anatomy instruction using virtual dissection tools in enhancing learning outcomes among undergraduate medical students.
Methods: A quasi-experimental study was conducted among 120 first-year MBBS students at a tertiary medical college. Students were randomized into two groups: Group A (n=60) received traditional dissection-based teaching, and Group B (n=60) received digital instruction using tools like 3D anatomy software and the Anatomage Table. Pre- and post-intervention assessments were conducted using MCQs and OSPEs. A feedback questionnaire evaluated student perceptions of clarity, engagement, and accessibility. Statistical analysis included paired and unpaired t-tests (p<0.05).
Results: Both groups showed significant post-test improvements (p<0.001). Group B had a slightly higher mean score (78.2 ± 6.5) than Group A (75.6 ± 7.1), though not statistically significant (p=0.067). Students in Group B reported greater satisfaction with visual clarity (92%), interactivity (87%), and accessibility (89%), while Group A appreciated the tactile learning and real-life anatomical variation of cadaveric dissection.
Conclusions: Virtual dissection tools are effective alternatives to traditional methods, enhancing engagement and visualization. However, each method has unique strengths that support anatomy learning.
Recommendations: A blended approach combining digital tools with cadaveric dissection is recommended to deliver a comprehensive and immersive anatomy education. Further studies should explore long-term learning outcomes and cost-effectiveness
We just want to be seen: A cross-sectional mixed-methods study on visibility, support systems, and institutional responses to same-sex relationships on South African University campuses.
Get PDFBackground Sexual and gender minority students in South African universities continue to experience marginalization, social exclusion, and limited institutional responsiveness to their needs. Although national policies promote equality, the realities on university campuses often fall short. This study aimed to explore how LGBTQ+ students in same-sex relationships navigate issues of visibility, support systems, and institutional responses within higher education settings.
MethodsA cross-sectional mixed-methods design was used. Quantitative data were collected from 50 self-identified LGBTQ+ students enrolled in three public South African universities through structured questionnaires. Participants varied in gender identity, sexual orientation, and academic year. Qualitative insights were gathered from 10 in-depth, semi-structured interviews. Quantitative data were analysed using descriptive statistics and correlation analysis, while qualitative data were subjected to thematic analysis based on Braun and Clarke’s (2006) six-phase framework.
ResultsQuantitative findings revealed that 70% of participants felt their sexual identity was either ignored or inadequately acknowledged by university authorities. Only 18% had accessed any form of formal institutional support. A positive correlation was found between perceived institutional support and self-reported psychological well-being (p < 0.05). Thematic analysis of interview narratives identified three dominant themes: (1) Invisibility and Silencing, a lack of safe spaces and representation; (2) Weak Institutional Support Structures, limited access to trained counsellors and LGBTQ+-inclusive services; (3) Policy Gaps and Inaction, institutional policies that exist on paper but lack implementation.
ConclusionLGBTQ+ students in same-sex relationships face significant challenges related to acceptance, mental health, and access to institutional support. Many feel invisible within the broader university environment, with policies often failing to translate into practical change.
RecommendationsUniversities should implement context-specific LGBTQ+ support services, such as safe spaces, peer support groups, and LGBTQ+-affirmative counselling. Institutional accountability mechanisms must be strengthened to ensure that inclusion policies are not only adopted but also effectively practiced
‘It’s Not a Weakness’: Lived Experiences, Support Systems, and Emotional Wellbeing in Caesarean Birth among Postpartum Women in Nigeria.
Get PDFBackground:
Caesarean section (CS) is an obstetric intervention for preventing maternal and neonatal complications. Despite its benefits, CS in Nigeria is influenced by cultural beliefs, stigma, and emotional responses, with limited research exploring how these factors affect women’s experiences and mental well-being after surgery. This study examined the lived experiences of postpartum women who delivered by CS in selected Nigerian health facilities, focusing on emotional well-being and support systems.
Methods:
A qualitative phenomenological design was employed in four Local Government Areas of Ibadan, Oyo State. Data were collected through 11 in-depth interviews and two focus group discussions involving 24 women aged 22–49 years who had undergone CS within the previous five years. Purposive sampling was used to ensure variation in age, education, and residence. Audio-recorded interviews were transcribed and analyzed thematically with ATLAS.
Results:
Of the 24 participants, thirteen resided in urban areas while eleven resided in rural areas. Five major themes emerged: (1) Pathways to caesarean delivery, highlighting that decisions were largely driven by medical necessity and often involved joint decision-making with spouses; (2) Emotional responses and mental adjustment, ranging from fear and anxiety to calm acceptance influenced by clinical communication and faith; (3) Sociocultural interpretations and stigma, including narratives that associate CS with weakness or spiritual failure; (4) Support systems and recovery experiences, with strong spousal, family, and respectful healthcare support reported as central to recovery; and (5) Future preferences and advice to others, where many participants expressed willingness to undergo CS again, emphasizing the primacy of maternal and child safety.
Conclusions:
Caesarean birth is more than a clinical procedure; it is a deeply social and emotional experience.
Recommendation:
Supportive communication from healthcare professionals, family involvement, mental health and counselling, and efforts to dispel negative cultural myths around CS are essential to improving women’s psychosocial outcomes
Prevalence and determinants of postnatal depression among mothers attending a tertiary care hospital in Hyderabad. A cross-sectional study
Get PDFBackground
Postnatal depression (PND) is a common yet underdiagnosed condition that impairs maternal well-being and child development.
Objectives
To determine the prevalence of PND among mothers attending a tertiary hospital in Hyderabad and to identify associated sociodemographic and obstetric factors.
Materials and methods
A cross-sectional study was conducted among 120 postnatal mothers within 24 weeks of delivery at the Departments of Obstetrics and Pediatrics, Neelima Institute of Medical Sciences, Hyderabad. Participants were grouped as 0–12 weeks and 13–24 weeks postpartum. The 10-item Edinburgh Postnatal Depression Scale (EPDS) was used, with scores >10 indicating possible depression. Sociodemographic and obstetric details were recorded, and associations were tested using chi-square analysis.
Results
The mean age was 26.8 ± 4.2 years. Most mothers were literate (89.2%), homemakers (71.7%), and from nuclear families (62.5%). Overall, 39 (32.5%) scored >10 on EPDS. Depression was more frequent in the 0–12 weeks group (38.3%) compared with 13–24 weeks (26.7%), though not significant. Significant associations were observed with maternal employment (p = 0.0008), female infant gender (p = 0.0008), domestic violence (p = 0.011), family substance abuse (p = 0.0003), and financial debts (p = 0.023). Education, family type, and delivery mode showed no significant association.
Conclusion
PND affects nearly one-third of mothers, with higher vulnerability in the early postpartum period. Psychosocial stressors, including employment status, gender of the newborn, violence, family substance abuse, and financial strain, were strongly associated with depressive symptoms. Recognition of both the prevalence and determinants is essential for timely interventions.
Recommendations
Routine mental health screening and psychosocial support should be integrated into maternal healthcare, with priority given to high-risk groups
Utility of Preoperative Upper Gastrointestinal Endoscopy in Reducing Post-Cholecystectomy Syndrome: An Analytical Cross-Sectional Study.
Get PDFBackground:Cholelithiasis is a prevalent gastrointestinal disorder treated by laparoscopic cholecystectomy. However, nearly 40% of patients develop post-cholecystectomy syndrome (PCS), often due to undiagnosed non-biliary upper gastrointestinal (GI) pathologies.
Objective:
To determine the utility of preoperative upper gastrointestinal (GI) endoscopy in identifying concomitant GI disorders and its effect on the occurrence of PCS in patients undergoing laparoscopic cholecystectomy.
Methods:
This analytical cross-sectional study was conducted at ESIC Medical College and PGIMSR, Bengaluru, over 18 months. A total of 130 patients with symptomatic cholelithiasis were enrolled and divided into two groups of 65 each. Group I underwent laparoscopic cholecystectomy without prior endoscopy, while Group II underwent preoperative endoscopy, and the identified lesions were treated before surgery. Postoperative follow-up was carried out for three months, and the incidence of PCS was compared between groups using Fisher's exact test.
Results:
Baseline demographic characteristics were similar between groups. Significant upper gastrointestinal pathology was detected in 55.4 % of patients in Group II, with gastroesophageal reflux disease (23.1 %), gastritis (13.8 %), and peptic ulcer disease (10.8 %) being common findings. At three-month follow-up, PCS symptoms were reported in 53.8 % of patients without endoscopy versus only 3.1 % of those who underwent preoperative endoscopy (p < 0.00001). The results demonstrate a strong association between preoperative endoscopic screening and reduced PCS incidence.
Conclusion:
Preoperative upper gastrointestinal endoscopy aids in detecting and managing coexisting upper GI disorders, thereby markedly reducing PCS. Routine or selective use of endoscopy is recommended in patients presenting with atypical pain, dyspepsia, or reflux symptoms before cholecystectomy. Further multicentric studies with longer follow-up are recommended to validate these findings and establish protocol-based implementation
Prevalence of anemia and its relation to outcome among children aged 1 month – 5 years hospitalized for pneumonia at a tertiary care hospital: A prospective cross-sectional study.
Get PDFBackground: Pneumonia remains a leading cause of morbidity and mortality in children under five years, particularly in low-resource settings. Anemia, a common comorbidity, exacerbates the severity and outcomes of pneumonia. Understanding the interplay between anemia and pneumonia-related outcomes is crucial for improving clinical management strategies.
Objective: To estimate the prevalence of anemia in children hospitalized with pneumonia and to assess its correlation with clinical severity, need for advanced respiratory support, blood transfusion, and outcomes.
Methods: A prospective cross-sectional study was conducted among 200 children aged 1 month to 5 years admitted with pneumonia at a tertiary care center. Clinical manifestations, hemoglobin levels, oxygen therapy requirements, need for blood transfusion, and outcomes were recorded. Anemia was classified based on WHO criteria. Data were analyzed using chi-square and Pearson correlation tests with significance set at p<0.05.
Results: Overall, anemia was observed in 68% of participants, with mild (40%), moderate (19.5%), and severe anemia (8.5%). Anemia was observed in 68% of participants, with mild (40%), moderate (19.5%), and severe anemia (8.5%). The need for advanced respiratory support increased with anemia severity; 39.1% of severely anemic children required mechanical ventilation (p<0.001). Blood transfusions were necessary in 30% of children with moderate anemia and 70% with severe anemia. Mortality was significantly higher among severely anemic children (50%) compared to non-anemic counterparts (14.3%) (p<0.001). Overall, 93% of children were discharged, while 7% succumbed to pneumonia, predominantly in the under-three age group.
Conclusion: Anemia significantly worsens clinical outcomes in pediatric pneumonia, increasing the need for intensive oxygen therapy, transfusions, and raising the risk of mortality. Early detection and aggressive management of anemia are pivotal to improving survival in pediatric pneumonia cases.
Recommendations: Routine anemia screening and prompt correction should be integrated into pediatric pneumonia management protocols to reduce respiratory complications and improve survival in resource-limited settings
Antimicrobial susceptibility patterns of Staphylococcus aureus causing cellulitis among adult patients attending clinical services at Kiruddu Referral Hospital, Kampala. A cross-sectional study.
Get PDFBackground
Staphylococcus aureus is responsible for most cases of cellulitis infections. Cellulitis is the most common bacterial infection on the skin surfaces in humans all over the world. The study aims to investigate the AST patterns of Staphylococcus aureus that cause cellulitis in adult patients.
Methods
A cross-sectional study analyzed 279 wound swabs from cellulitis patients at Kiruddu Referral Hospital, Kampala. Samples were cultured on Mannitol Salt, Blood, and MacConkey Agars. Staphylococcus aureus was identified by Gram stain, catalase, and coagulase tests; other isolates (Streptococcus pyogenes, Escherichia coli, Klebsiella pneumoniae) were confirmed biochemically. Antimicrobial susceptibility was determined using Kirby-Bauer disk diffusion on Mueller-Hinton agar, interpreted per CLSI (2023) guidelines. Susceptibility frequencies were calculated with Microsoft Excel.
Results
Among 279 patients, 56.3% of the participants were female, and 31.5% were aged 36–45 years. 50.5% were married, and 30.5% had completed secondary education. Staphylococcus aureus was the predominant pathogen (56.6%, n=158). Of these, 43.7% were methicillin-resistant (MRSA). Susceptibility to key antibiotics was: vancomycin (96.8%), quinupristin/dalfopristin (81.6%), clindamycin (73.4%), and trimethoprim-sulfamethoxazole (64.6%). Streptococcus pyogenes showed high penicillin susceptibility (90.0%), while Gram-negative isolates exhibited significant resistance to commonly used antibiotics.
Conclusion
High MRSA prevalence and significant antibiotic resistance were found, necessitating routine susceptibility testing and strengthened stewardship to guide effective cellulitis treatment
Recommendation
The Ministry of Health should incorporate TB LAM Ag test strips into the national HIV/TB diagnostic guidelines, especially for patients with advanced immunosuppression