95 research outputs found
Adeniyi, Oladele Vincent
Title: DR. Position: Lecturer ORCID: Faculty and Department: Health Sciences; Family Medicine Office Number and Building * CECILIA MAKIWANE HOSPITAL, MDANTSANE Campus: EAST LONDON HOSPITAL COMPLEX Phone: +27793110232 Fax: +2743 761 1158 Email: [email protected]; [email protected] Qualification: FCFP, MMED (FAM MED), MPHIL, PHD Expertise: Research design, implementation science, non-communicable diseases and HIV epidemiology, General Practice My site: https://scholar.google.co.za/citations?hl=en&user=ocLXSxEAAAAJ&view_op=list_works&sortby=pubdat
Genetic diversity, resistance profile of hiv and risk assessment of mother-to-child transmission in pregnant women on antiretroviral therapy in the Eastern Cape, South Africa
Despite the initiation of life-long ART in HIV-infected pregnant women, the rate and determinants of infant HIV transmission are not known, especially in the poor resource settings of the Eastern Cape, South Africa. Maternal anti-retroviral therapy (ART) is crucial for elimination of mother-to-child transmission (MTCT) of HIV. However, the inevitable risks of emergence of HIV drug resistance poses significant threat to achieving this goal of HIV-free generation and keeping mothers alive. Also, it is unclear if women with high viral load at delivery have acquired clinically relevant mutations, which could confer resistance to the ART, thus, further increasing the risks of motherto-child transmission of HIV-drug resistance strains. In addition to the gaps identified in the prevention of mother-to-child transmission (PMTCT) context, the understanding of regional epidemics is crucial to the broader epidemiological profiling of HIV infections in the country. Despite the rapid influx of foreign nationals to South African and Eastern Cape Province, there has not been any molecular epidemiological studies profiling the HIV diversity in the Eastern Cape
Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults
Inequality in uptake of isoniazid prevention therapy and Mantoux test among pregnant women with HIV in the Eastern Cape, South Africa
Maternal knowledge and attitude to early infant HIV diagnosis
Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: The global targets of zero deaths from AIDS-related illness by the year 2015 can only be met if all HIV infected infants can be diagnosed and initiated on anti-retroviral therapy as early as four to six weeks. WHO/UNICEF reported in 2010 that only 8% of eligible infants were tested worldwide. There seems to be more attention directed towards service delivery and less attention on empowering mothers to make voluntary decision to access the services. The influence of maternal knowledge of infant HIV infection and the impact on the attitude towards knowing the status of their children so early in life remains uncertain. The aim of this study was to explore the knowledge and attitude of the HIV positive mothers to early infant diagnosis in order to make strategic recommendations to the health authorities on how to scale up the services in the various health facilities. A qualitative study was conducted in two health centres in King Sabata Dalindyebo Municipality of Eastern Cape Province, South Africa. This qualitative study drew in-depth interview with twenty-four HIV positive mothers/ exposed infants’ pair attending the immunization clinics. The results obtained were presented to two focus groups for discussion and validation of findings. Thematic analysis explored the emerging themes relevant to the objective of the study and health authorities. The study found that there is a high level of awareness about infant HIV infection. Majority of the participants were aware of MTCT of HIV and the timing of transmission (pregnancy, delivery and breastfeeding). Majority of the participants were aware about the protection offered by maternal exposure to ARVs however, only few participants knew about the risk of transmission despite ARV use. Majority of the participants did not know the right time to bring their infant for HIV test. Majority of the participants never thought about HIV test for their infant as early as six weeks. Majority of the mothers have fears about bringing their infants for HIV test so early. They have concerns about recommending early infant diagnosis to other children in their community due to the perceived disclosure of their own status. The study found that despite good knowledge of mothers about infant HIV infection and prevention methods, the knowledge about early infant diagnosis is lacking. The attitude of the mothers to knowing the status of their infant so early in life is challenging for them. The health authorities have more work to do to empower these mothers with knowledge about early infant diagnosis and early ART initiation to increase the chances of survival of HIV infected infants.AFRIKAANSE OPSOMMING: Die internasionale mikpunt van geen sterftes weens vigsverwante siektes teen die jaar 2015 kan slegs bereik word as alle MIV-besmette babas reeds op vier tot ses weke gediagnoseer word en antiretrovirale terapie (ART) ontvang. Die WGO/UNICEF het in 2010 berig dat slegs 8% van babas wat getoets moet word, in werklikheid wêreldwyd getoets is. Dit blyk dat meer aandag aan dienslewering en minder aan die bemagtiging van moeders om die vrywillige besluit om van die dienste gebruik te maak, geskenk word. Die invloed van moeders se kennis op MIV-besmetting van babas en die impak op die houding teenoor kennis van die status van hul kinders op so ’n vroeë ouderdom is steeds onbekend. Die doel van hierdie studie was om die kennis en houding van MIV-positiewe moeders rakende vroeë diagnose van babas te ondersoek ten einde strategiese aanbevelings aan die gesondheidsowerhede te maak oor verbetering van die dienste in die onderskeie gesondheidsfasiliteite. ’n Kwalitatiewe studie is in twee gesondheidsentrums in King Sabata Dalindyebo-munisipaliteit in die provinsie Oos-Kaap, Suid-Afrika, onderneem. Dit het diepte-onderhoude met 24 MIV-positiewe moeders/blootgestelde babas wat die immuniseringsklinieke besoek het, behels. Die resultate is aan twee fokusgroepe vir bespreking en bekragtiging van die bevindings voorgelê. Tydens ’n tematiese ontleding is die temas wat aan die lig gekom het wat betrekking het op die doelstellings van die studie en gesondheidsowerhede ondersoek. Daar is gevind dat daar ’n hoë vlak bewustheid van MIV-besmetting van babas is. Die meerderheid van die deelnemers was bewus van moeder-na-kind-oordrag van MIV en die tydsberekening van oordrag (swangerskap, geboorte en borsvoeding). Die meerderheid van die deelnemers was ook bewus van die beskerming wat gebied word deur die moeder se blootstelling aan ART, maar net ’n paar deelnemers het egter geweet van die risiko van oordrag ongeag die gebruik van ART. Die meerderheid van die deelnemers het nie geweet wat die korrekte tyd is om hul baba vir ’n MIV-toets te bring nie. Die meerderheid het nog nooit ’n MIV-toets vir hul baba voor die ouderdom van ses weke oorweeg nie. Die meerderheid van die moeders was bang om hul babas so vroeg reeds vir MIV te laat toets. Hulle is begaan oor die aanbeveling van vroeë diagnose vir ander mense in hul gemeenskap weens die waargenome bekendmaking van hul eie status. Die studie het bevind dat ongeag moeders se grondige kennis van MIV-besmetting van babas en voorsorgmaatreëls, daar ’n gebrek aan kennis oor vroeë diagnose van babas is. Die houding van die moeders teenoor kennis van die status van hul baba op so ’n vroeë ouderdom hou vir hulle ’n uitdaging in. Die gesondheidsowerhede moet hulle daarop toespits om hierdie moeders sonder kennis oor vroeë diagnose van babas en vroeë nakoming van ART te bemagtig ten einde MIV-besmette babas se kanse op oorlewing te verhoog.Master
Low awareness and use of pre-exposure prophylaxis among adolescents and young adults in high HIV and sexual violence prevalence settings
Prevalence, awareness, and determinants of type 2 diabetes mellitus among commercial taxi drivers in buffalo city metropolitan municipality South Africa
Management approach of patients with violent and aggressive behaviour in a district hospital setting in South Africa
Aggressive and violent behaviour is very common in the hospital setting. Simple agitation may unpredictably progress to overt aggression and violence by any patient in the emergency centres (ECs). Aggressive behaviour often manifests in forms of verbally abusive language, verbal threats and intimidating physical behaviour. Violent behaviour comprises the intentional use of physical force or power, threatened or actual, against self (suicidal), or another (homicidal) or properties, group or community, that could potentially result in injuries, death, psychological harm or deprivation. Therefore, individuals with unusual agitation and aggression should be treated as an emergency in both the community and healthcare settings in order to mitigate the progression to physical violence. Whilst the incidence and prevalence of aggressive and violent behaviour are higher in individuals with an underlying mental disorder, substance use disorder or comorbid mental disorder and substance use disorder, other individuals can also present with these behaviours in the ECs. Therefore, the front-line clinicians must be knowledgeable and competent in managing patients with aggressive behaviour with a view to de-escalate the situation and preventing or curtailing violence. This paper presents an evidence-based approach for managing patients with aggressive and violent behaviour, including a review of the steps for admitting patients for assisted or involuntary care
Protocol for a Delphi Consensus Study to Determine the Essential and Optional Ultrasound Skills for Medical Practitioners Working in District Hospitals in South Africa
With increasing access to point of care ultrasound (POCUS) at district hospitals in South Africa, there is a lack of standardisation of skillsets among medical practitioners working at this level of care. This study protocol aims to use the Delphi process to achieve expert consensus on the essential and optional ultrasound skills required for medical practitioners working in district hospitals in South Africa. In alignment with the Delphi method, several iterative rounds will be implemented from June to November 2022. Purposive sampling will be conducted, through the recruitment of two representatives from each academic department of family medicine and two medical doctors working in district hospitals in each province in the country (N = 36). The POCUS skillsets published by the American Academy of Family Physicians will be circulated in the first iterative round, following which participants may suggest further additions. Once a consensus target of 70% has been achieved, the Delphi process will be finalised. The Delphi process and data analysis will be facilitated by an online Delphi platform. Findings from the study will provide insight into the design of the curriculum for POCUS training for medical practitioners in district hospitals and registrars in family medicine departments across the country
Single Nucleotide Polymorphisms in Amlodipine-Associated Genes and Their Correlation with Blood Pressure Control among South African Adults with Hypertension
Objective: This study describes the single nucleotide polymorphisms (SNPs) in amlodipine-associated genes and assesses their correlation with blood pressure control among South African adults with hypertension. Methods: In total, 304 hypertensive patients on amlodipine treatment belonging to the indigenous Swati, Xhosa and Zulu population groups of South Africa were recruited between June 2017 and June 2019. Participants were categorized into: controlled (blood pressure < 140/90 mmHg) and uncontrolled (blood pressure ≥ 140/90 mmHg) hypertension. Thirteen SNPs in amlodipine pharmacogenes with a high PharmGKB evidence base were selected and genotyped using MassArray (Agena Bioscience(TM)). Logistic regression was fitted to identify significant associations between the SNPs and blood pressure control with amlodipine. Results: The majority of the participants were females (76.6%), older than 45 years (89.1%) and had uncontrolled hypertension (52.3%). Of the 13 SNPs genotyped, five SNPs, rs1042713 (minor allele frequency = 45.9%), rs10494366 (minor allele frequency = 35.3%), rs2239050 (minor allele frequency = 28.7%), rs2246709 (minor allele frequency = 51.6%) and rs4291 (minor allele frequency = 34.4%), were detected among the Xhosa participants, while none were detected among the Swati and Zulu tribal groups. Variants rs1042713 and rs10494366 demonstrated an expression frequency of 97.5% and 79.5%, respectively. Variant TA genotype of rs4291 was significantly associated with uncontrolled hypertension. No association was established between blood pressure response to amlodipine and the remaining four SNPs. Conclusions: This study reports the discovery of five SNPs in amlodipine genes (rs2239050, rs2246709, rs4291, rs1042713 and rs10494366) among the indigenous Xhosa-speaking tribe of South Africa. In addition, the TA genotype of rs4291 was associated with blood pressure control in this cohort. These findings might open doors for more pharmacogenomic studies, which could inform innovations to personalised anti-hypertensive treatment in the ethnically diverse population of South Africa
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