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INTENTION TO HAVE AN HIV TEST: MODELING VOLUNTARY COUNSELING AND TESTING USING THEORY OF REASONED ACTION
No full textIntention to have an HIV test: Modeling voluntary counseling and testing using
Theory of Reasoned Action
Introduction
There is a low uptake of HIV test in Zimbabwe despite the population’s knowledge about
HIV/AIDS as shown in studies on knowledge, attitudes and practices (KAP). Success in
alleviating the spread of HIV/AIDS can only be fully realised if people take up HIV tests
on their decision. In order to solicit information from people on their intentions towards
HIV test, this study was carried out in two high-density suburbs of Harare namely Glen
View and Kuwadzana. The HIV will remain unabated if HIV-positive people who do not
know their HIV status take the initiative to make their status known. The study aims to
model determinants of intention to have an HIV test using the theory of reasoned action
framework.
Study design, participants and methods
An analytic cross sectional study was conducted in randomly selected enumeration areas
in Glen View and Kuwadzana high density suburbs of Harare, Zimbabwe. Data was
collected through a self-administered questionnaire distributed to 150 consenting
participants, men and women aged 15 to 49 years, who had never tested for HIV and who
reside in the two areas. The theoretical framework used was Theory of Reasoned Action
(TRA). Two types of response variables on intention to have an HIV test were used. The
first was dichotomous and used as a classification variable in discrimination analysis. The
second was a continuous variable derived as a score from items in the construct and used
in linear regression analysis.
Results
Data was analysed based on 134 questionnaires collected from participants, of which 61
(46%) were from Glen View and 73 (55%) Kuwadzana; 86 (65%) were females and 47
(35%) males. Sixty-nine (52%) were married and/or living together while 53 (40%) were
single and/or never married and 99 (76%) were not employed. Sixty-six (49%) had an
intention to have an HIV test within three months. Linear regression for intention on
attitudes and subjective norms based on scores from factor analysis showed that only
subjective norms [coefficient=0.67; 95% CI: 0.50 0.84] predicted intention. Linear
regression for intention on attitudes and subjective norms based on belief-based attitudes
and subjective norms showed that both attitudes [coefficient=0.14; 95% CI: 0.09 0.20]
and subjective norms [coefficient=0.21; 0.05 0.37] were predictors of intention. Attitudes
[coefficient=0.88] had a greater contribution in discriminating individuals into their
groups than subjective norms [coefficient=0.30].
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Conclusion
The study has shown that using factor analysis, the direct measure of the subjective
norms construct is the main determinant of intention to have an HIV test as compared to
attitudes. The same study has also shown that both belief-based subjective norms and
belief-based attitudes are determinants of intentions. Attitudes and subjective norms
obtained from scores based on Cronbach’s alpha predict intentions to HIV testing better
than those based on factor analysis. Using discriminant analysis, the study has shown that
the attitudes construct is better than the subjective norms construct in the discriminating
participants into the groups with intention to test and with no intention
Traumatic asphyxia during stadium stampede
No full textObjectives: To present a series of cases of survivors and non-survivors of traumatic asphyxia from a single mass casualty incident in Zimbabwe and a review of the literature.
Design: Descriptive case review.
Setting: Parirenyatwa Hospital is a tertiary referral 1 000 bed teaching hospital in Zimbabwe.
Results: Survivors (n = 4) displayed the classic signs of traumatic asphyxia of conjunctival haemmorhages, petechial blue-purple discoloration of head and neck and neurological findings of confusion or unconsciousness and convulsions. Non-survivors (n = 12) showed more varied signs but all showed petechiae and with a history of being crushed. On-site resuscitation and triage was absent, reducing the chance of identifying potential survivors at the scene.
Conclusion: The outcome in traumatic asphyxia is improved by rapid restoration of ventilation and circulation. The epidemiology of traumatic asphyxia in Zimbabwe is unknown but the conditions predisposing to it are present. Closer integration between hospital and pre-hospital services will permit better management of major trauma patients and mass casualty events
Levels of chromium in Zimbabwean foods and its importance in carbohydrate metabolism
No full textStaple foods eaten by Zimbabweans were collected and analysed for their chromium content. Organic matter was destroyed by a wet oxidation procedure using concentrated sulphuric and nitric acids. The food digest was directly aspirated into atomic absorption spectrophotometer (AAS) models Varians AA-1275 and AA-5-275. The remainder of each digest had pentan - 2,4 dione added to it. The Cr complex formed was extracted in 4 methyl - pentan - 2 - one. Unfortunately no Cr was detected in the extract
Water, leafy vegetables, naatjies (tangarines), oranges and beverage drink such as fizzy orange cordial and diabetic orange had either no Cr at all or only very low levels. Cr content in some fruits, such as bananas, apples and avocado pears, and in sweet potatoes and mealie-meal was moderate (mean 10,5 + 1,9 meg) as compared to cheese, groundnuts, cucumbers, maize on the cob, rapoko and meat products, such as liver, which were found to be rich sources of Cr. These ranged from 15,2 to 49,6 meg/g.
The importance of dietary chromium in the metabolism of carbohydrates is also discussed
Factors associated with hospital admissions among registered diabetes mellitus patients in Guruve and Mazowe districts, Mashonaland Central province, Zimbabwe.
No full textIntroduction
Diabetes mellitus is among the top five chronic conditions contributing to Out Patients Department attendance in Mazowe and Guruve Districts. This study sought to identify the contributory factors that are associated with the increase in hospital admissions among diabetes mellitus patients in Guruve and Mazowe Districts so as to inform interventions.
Methods: The study was an analytic cross-sectional study. A census of all the 202 registered patients attending diabetes mellitus review appointments at Guruve, Howard, Concession and Mvurwi hospitals was done. Interviewer-administered pretested questionnaires were used to collect data. Epi info version 3.5.1 was used to create frequencies, proportions and prevalence odds ratios to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables. Ethical approval was sought from all relevant authorities while informed consent was obtained from all study participants.
Results: Of the 202 study sample, 43.6% had an admission history due to diabetes mellitus. Being female [POR 2.43 (95%CI: 1.25-4.73)], being unemployed [POR 1.97 (95%CI: 1.09-3.56)] and being less educated (primary level and below)[POR 2.56 (95%CI: 1.38-4.77) were statistically significant risk factors for hospitalisation due to diabetes mellitus.
Those patients on insulin [POR 2.93 (95%CI: 1.33-6.48)], those resident in communities where diabetes was not discussed at public meetings and gatherings [POR 3.73 (95%CI: 1.68-8.28)], those with longer duration on treatment for diabetes (4+ years) [POR 2.30 (95% CI: 1.30-4.41)], older cases (>1 year) [POR 3.04 (95%CI: 1.47-6.28)] and support group members [POR 4.77 (95% CI: 1.50-15.18)] had a higher likelihood of getting hospitalised and this was statistically significant.
Insulin medication [AOR 2.74 (95% CI: 1.22-7.27) p= 0.0168], low educational level (primary and below) [AOR 2.74 (95% CI: 1.34-5.58) p= 0.00570], having long been diagnosed with diabetes (1year+) [AOR 3.06 (95% CI: 1.38- 6.79) p=0.00570] and residing in areas where there is no diabetes mellitus education at community level [AOR 3.86(95% CI: (1.60-9.32) p=0.00260], were independent factors associated with hospital admissions due to diabetes
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mellitus in Guruve and Mazowe districts that remained statistically significant after logistic regression analysis.
Conclusion and Recommendations
Independent predictors of hospitalisation due to diabetes were type of treatment, level of education, community based health education and time lapse after diabetes diagnosis. In addition to provision of adequate services and supplies to diabetes mellitus clients, the District Health Executive needs to take an ecological approach towards the inclusion of the wider family and community support structure in effecting lifestyle modifications among diabetes mellitus clients that is conducive to sustain control measures
Evaluating factors associated with failed induction of labour in patients undergoing induction with titrated oral misoprostol at Harare hospital maternity
No full textThe blood pressure in advanced urinary bilharziasis
No full textHypertension may at times ensue when there is back pressure ori one or both kidneys, from disease in Lhe ureter or from increased bladder tension which is reflected back on the kidneys. It would seem, however, that hypertension does not often complicate such obstructive lesions in the lower urinary tract. But in his Croonian lecture McMichael (1961) lists hydronephrosis as one of the factors which may cause hypertension. Frequent and often serious lesions are found in the bladder and ureter in urinary bilharziasis. In the bladder we meet fibrosis, calcification and reduced capacity with increased intravesical pressure; in the ureter either dilatation or stenosis or both commonly associated with hydronephrosis (Honey and Gelfand, 1960). Gelfand (1961) points out that in bilharzial hydronephrosis hypertension is rare and discusses the relationship between advanced urinary bilharziasis and the nephrotic syndrome or pyelonephritis
Towards quality of care i n mental health services
No full textMental health is an integral part of health and is defined as “a state of mental well being where an individual realises their full potential, can cope with the normal stresses of life and can contribute productively to their community” (WHO). Mental health disorders therefore affect not only individual lives but their families, the communities they are part of and the nation’s social and economic progress.
One in four people worldwide are affected by a mental or neurological disease in their lifetime making mental health disorders one of the leading causes of global disease burden (WHO). Depression is now the leading cause of disability affecting over 300 million people worldwide (Friedrich, 2017). Depression is also a major contributor to suicide which claims more than 800 000 lives a year and has become the second leading cause of death among young people (WHO, 2014). Substance use makes up a large proportion of the disease burden among young people (Gore, 2011). In Africa the prevalence of substance use is rising and the demand for treatment is high (Parry, 2004). Although effective treatments for most mental health disorders including depression and substance use exist, most patients do not get adequate help (Patel, 2010).
This National Mental Health Strategic Plan of 2019 to 2023 follows the Zimbabwe National Strategic Plan for Mental Health Services of 2014 to 2018 which was based on the Zimbabwe National Mental Health Policy of 2007 before which mental health services had been guided by the Zimbabwe Mental Health Plan of Action of 1984. These previous policy and planning documents were all developed in consultation with various stakeholders as was done for this plan as well.
This strategic plan aims to improve mental care in Zimbabwe by: improving the quality of our mental health service delivery and patient care in line with international best practice; improving mental health awareness and empowering our communities; promoting research and development of locally relevant, innovative solutions to challenges in our mental health system; reviewing our legislation in line with current international guidelines and strengthening our human resources through training and skills development.
From 2019 to 2023 we will target several high priority areas including improving quality of care in all mental health units; mhGAP training of non specialist health workers to improve mental health care in primary care facilities; alcohol and substance use disorder treatment; community awareness of mental health issues as well as community participation in treatment. We hope through this strategic plan, to strengthen the mental health of our nation and improve the quality of life of many Zimbabweans affected by mental illness
The relationship between pregnancy induced hypertension (PIH) self care knowledge and hypertension control among pregnant mothers aged 18 to 49 years in Bindura District
No full textHypertension control among pregnant mothers with pregnancy induced hypertension (PIH) appears difficult to achieve. Part of the reason for poor control of hypertension in these women might be limited PIH self care knowledge. The purpose of this study was to examine the relationship between PIH self care knowledge and hypertension control among pregnant women with PIH in Bindura District. Orem’s self care model guided this study. A descriptive correlational study design was used. A simple random sample of 78 participants was recruited and data collected using a mercury sphygmomanometer and stethoscope for the blood pressure levels and face to face interviews for sample demographics and PIH self care knowledge. The Demographic Data Questionnaire (DDQ) and PIH Self Care Knowledge Questionnaire (PIHSCKQ) developed by the investigator guided the face to face interviews. Data were analysed using descriptive and inferential statistics (Pearson Correlation Co-efficient). The SPSS.pc Statistical Package was used for data analysis. The results showed that PIH self care knowledge was generally good since 58 (74.3%) scored PIH self care knowledge scores above the mean score of 24 out of 48. Generally, hypertension control was adequate. Forty-three (55.1%) had blood pressure levels below the cut off level of 140/90mmHg. The correlation coefficient showed a very weak, non significant relationship (r=0.-175). Although the relationship was not statistically significant, the findings demonstrated that PIH self care knowledge has some influence on hypertension control. Continuous reinforcement of PIH self care knowledge skills is essential during antenatal teaching of clients
Lethal congenital malformations in the Greater Harare Obstetric Unit during 1983
No full textThere were 97 perinatal death attributed to congenital malformations in the Greater Harare Obstetric Unit during 1983. This gives an incidence of 2.14/1 000 total births. The central nervous system was the most frequently involved system, affected in 40 (41.2%) of the deaths. The commonest malformation was anencephaly present in 17 (42.5%) of the central nervous system defects. Mothers of babies dying from a lethal congenital malformation tended to be older than the general obstetric population
Relationship between knowledge of complications and health seeking behaviour among pregnant women with pregnancy induced hypertension aged 18 to 28 years at Chitungwiza Central Hospital
No full textPregnancy induced hypertension is a serious pregnancy complication associated with fatal complications on the mother and baby. The purpose of this descriptive correlational study was to describe and examine the relationship between knowledge of PIH complications and health seeking behaviour among pregnant women with PIH complications aged 18 to 28 years at Chitungwiza Central Hospital.. A convenient sample of 80 pregnant women were interviewed using an instrument comprising the demographic questionnaire, Health Seeking Behaviour questionnaire and Knowledge of PIH complications questionnaire. A Health Belief Model was used to guide the study. Data was analyzed using descriptive statistics, Pearson’s correlational, coefficient test and simple regression.
Study findings indicated that 65 (81,3%) subjects scored above 50% revealing good knowledge of PIH complications. Seventy-two (90%)scored 18-34 revealing bad health seeking behaviour. Data analysis indicated that knowledge of PIH complications and health seeking behaviour were positively correlated and significant (r = .319, p = < .01). Convulsions, headache, generalized oedema, reduced urine output and blurred vision were attributed to bad airs/evil spirits hence faith healers were consulted first before coming to hospital. Simple regression analysis R2 = .102 (F = 8.844. p = < .01) explains 10% variance in Health Seeking behaviour. Major recommendations are that there should be a public awareness on signs and symptoms of PIH complications such as uncontrolled bleeding of sudden onset, facial twitching, confusion and reduced urine output and education stressing the importance of reporting to hospital quickly on observing PIH complications. Use of Rosenstock Health Belief Model assisted in identifying the health seeking behaviours of pregnant women with PIH complications aged18-28