PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “SOUTH AFRICA”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources
PubMed2000

Availability of condoms in urban and rural areas of KwaZulu-Natal, South Africa.

BACKGROUND: Promoting condom use to prevent HIV transmission is futile if condoms are not readily available. GOAL: This study assessed condom availability in clinics, shops, and other outlets in urban and rural South Africa. STUDY DESIGN: Snowball sampling was used to select 70 private-sector and public-sector outlets. One male and one female black fieldworker were posed as clients seeking condoms to assess condom availability and provider attitudes. RESULTS: Condoms were available in nine (100%) public clinics, in five of nine (55%) private doctor's rooms, and in only 5 of 52 (10%) nonhealth outlets. Access was limited in the public sector by clinic opening times, inadequate clinic signs and markings, and by some providers' attitudes. CONCLUSION: A major opportunity to make condoms available in nonhealth outlets in rural areas and urban townships is being missed in South Africa. Above all, the high level of condom awareness is not being matched by easy availability.

Condoms↗
PubMedDate not supplied

Manganese--a public health concern: its relevance for occupational health and safety policy and regulation in South Africa.

Concerns about the effects of low-level manganese exposures on human health arise at a time when South Africa finds itself in competition with newcomers to the market economy, China and the CIS. This case study illustrates how decisions about occupational health and safety and the environment are influenced by incompleteness of scientific knowledge, competing interests, differences over what is fair or just, and the compartmentalization of public policy. In addition, an assessment is made of the ability of the occupational health and safety system in South Africa in its current form to address the challenges posed by manganese-related issues. The importance of tracking developments abroad, strengthening participatory processes, developing national policy, linking economic policy and OHS policy, and establishing appropriate trade agreements is stressed.

Adult↗
PubMed1993

Professional constructions of a 'lay' illness: 'nerves' in a rural 'coloured' community in South Africa.

As part of a larger study, medical practitioners working in Mamre, a 'coloured' village close to Cape Town, South Africa, were interviewed concerning their use of the term 'nerves' in interaction with their patients. Contrary to the initial perception of researchers and some clinicians, the term is not simply a folk category. It does, however, represent a medium through which psychosocial issues are discussed in the clinical encounter. Differences in the usage of the term by different practitioners seemed to indicate different attitudes towards patient care. The data are presented and discussed in the context of debates concerning the development of more accessible and responsive health services in a future South Africa, and the information gleaned has implications for future training of clinicians.

Black or African American↗
PubMed1997

Comparison of cost effectiveness of directly observed treatment (DOT) and conventionally delivered treatment for tuberculosis: experience from rural South Africa.

OBJECTIVE: To conduct an economic evaluation of directly observed treatment (DOT) and conventionally delivered treatment for the management of new cases of tuberculosis in adults. DESIGN: Community based directly observed treatment, which has been implemented in the Hlabisa district of South Africa since 1991, was compared with a conventional approach to tuberculosis treatment widely used in Africa. Each was assessed in terms of cost, cost effectiveness, and feasibility of implementation within existing resource constraints. SETTING: Hlabisa Health District, South Africa. SUBJECTS: Adult patients with new cases of tuberculosis on smear testing; the number of cases increased from 20 per month to over 100 from 1991 to 1996. MAIN OUTCOME MEASURES: Cost of case management in 1996, cost effectiveness in terms of the cost per case cured, and bed requirements in comparison with bed availability for the 1990, 1993, and 1996 caseload. Costs are expressed in US dollars at values for 1996. RESULTS: Directly observed treatment was 2.8 times cheaper overall than conventional treatment ($740.90 compared with $2047.70) to deliver. Directly observed treatment worked out 2.4-4.2 times more cost effective, costing $890.50 per patient cured compared with either $2095.60 (best case) or $3700.40 (worst case) for conventional treatment. The 1996 caseload of tuberculosis required 47 beds to be dedicated to tuberculosis to implement directly observed treatment, whereas conventionally delivered treatment would have required 160 beds; the current number of beds for tuberculosis treatment in Hlabisa is fixed at 56. CONCLUSIONS: Because of the reduced stay in hospital, directly observed treatment is cheaper, more cost effective, and more feasible than conventional treatment in managing tuberculosis in Hlabisa, given the existing hospital bed capacity and the escalating caseload due to the HIV/AIDS epidemic. Such results may hold elsewhere, and wherever conventional tuberculosis management is practised a switch to directly observed treatment will increase hospital capacity to cope with a growing caseload.

Adult↗
PubMed1996

Directly observed therapy for tuberculosis in rural South Africa, 1991 through 1994.

OBJECTIVES: This paper describes an audit of a community-based tuberculosis treatment program involving directly observed therapy in South Africa. METHODS: A program audit of 2473 consecutive tuberculosis patients in Hlabisa Health District, KwaZulu/Natal, South Africa, was conducted between 1991 and 1994. RESULTS: Monthly admissions increased from 34 per month in 1991 to 66 in 1994. Of 2186 patients managed in Hlabisa, 1903 (87%) received directly observed therapy. Of those receiving directly observed therapy, 1034 (55%) were supervised by volunteers; 743 (72%) of these were supervised by storekeepers. Among those patients managed locally, 1679 (85%) of 1967 surviving patients completed treatment. Completion rates for patients supervised by health workers and non-health workers were the same. Completion fell from a high of 90% in 1992 to 78% in 1994. Mortality increased from 5% in 1991 to 10% in 1994. CONCLUSIONS: Community-based directly observed therapy that uses an intermittent drug regime and volunteers as supervisors can achieve high treatment completion rates for tuberculosis, even in resource-poor settings.

Adult↗
PubMed2001

New approaches to spatially analyse primary health care usage patterns in rural South Africa.

OBJECTIVE: To develop indices to quantitatively assess and understand the spatial usage patterns of health facilities in the Hlabisa district of South Africa. METHODOLOGY: We mapped and interviewed more than 23 000 homesteads (approximately 200 000 people) in Hlabisa district, South Africa and spatially analysed their modal primary health usage patterns using a geographical information system. We generated contour maps of health service use and quantified the relationship between clinic catchments and distance-defined catchments using inclusion and exclusion error. We propose the distance usage index (DUI) as an overall spatial measure of clinic usage. This index is the sum of the distances from clinic to all client homesteads divided by the sum of the distances from clinic to all homesteads within its distance-defined catchment. The index encompasses inclusion, exclusion, and strength of patient attraction for each clinic. RESULTS: Eighty-seven per cent of homesteads use the nearest clinic. Residents of homesteads travel an average Euclidean distance of 4.72 km to attend clinics. There is a significant logarithmic relationship between distance from clinic and their use by homesteads (r(2)=0.774, P < 0.0001). The DUI values range between 31 and 198% (mean=110%, SD=43.7) for 12 clinics and highlight clinic usage patterns across the district. CONCLUSIONS: The DUI is a powerful and informative composite measure of clinic usage. The results of the study have important implications for health care provision in developing countries.

Geography↗
PubMedDate not supplied

Health care provision and surgical education in South Africa.

Apartheid policies have led to inequalities in the delivery of health care and the training of surgeons in South Africa. The nation's population of 33 million is comprised of 73.6% Blacks, 14.8% Whites, 8.8% Coloureds, and 2.7% Asians. Only 17% of the population are covered by medical insurance (78% of Whites, 28% of Asians, 26% of Coloureds, 4% of Blacks) that funds the private sector which accounts for 46% of the nation's total health care expenditure of 9.2156 million rand. The remainder receive care from curative state hospital based services, which consume 77% of the public expenditure on health. Preventive and promotive health services account for 23%. Only 3.2% of South Africa's gross national product is spent on health care provision for 80% of the population--well short of the World Health Organization's recommendation of 5.8%. This figure translates into a per capita expenditure of 138, 340, 356, and 597 rands for Blacks, Coloureds, Asians, and Whites, respectively. Eight medical schools produce just over 900 graduates per year, 80% of whom are white. The medium of instruction is English at five (Cape Town, Witwatersrand, Natal, MEDUNSA, and Transkei) and Afrikaans at three (Pretoria, Stellenbosch, and Bloemfontein). Natal and MEDUNSA are creations of apartheid and have graduated almost all the Black South African doctors, of whom only 15 are practicing surgeons. Many universities are cognizant that dramatic change is needed to redress such imbalances, and admission policies are changing.(ABSTRACT TRUNCATED AT 250 WORDS)

Delivery of Health Care↗
PubMed2025

Genomic insights into Shigella species isolated from small ruminants and manure in the North West Province, South Africa.

This study investigated Shigella species' antibiotic resistance patterns and genomic characteristics from small ruminants and manure collected in Potchefstroom, North West, South Africa. Whole genome sequencing was used to determine resistome profiles of Shigella flexneri isolates from small ruminants' manure and Shigella boydii from sheep faeces. Comparative genomics was employed on the South African 261 S. flexneri strains available from GenBank, including the sequenced strains in this study, by investigating the serovars, antibiotic resistance genes (ARGs), and plasmid replicon types. The S. flexneri strains could not be assigned to known sequence types, suggesting novel or uncharacterized lineages. S. boydii R7-1A was assigned to sequence type 202 (ST202). Serovar 2A was the most common among South African S. flexneri strains, found in 96% of the 250 compared human-derived isolates. The shared mdf(A) was the most prevalent gene, identified in 99% of 261 S. flexneri genomes, including plasmid replicon types ColRNAI_1 (99%) and IncFII_1 (98%). Both species share a core set of resistance determinants mainly involving &#x3b2;-lactams (ampC1, ampC, ampH), macrolides (mphB), polymyxins (eptA, pmrF), multidrug efflux pumps (AcrAB-TolC, Mdt, Emr, Kpn families), and regulatory systems (marA, hns, crp, baeRS, evgAS, cpxA, gadX). However, S. boydii possesses additional resistance genes conferring resistance to tetracyclines (tet(A)), phenicols (floR), sulphonamides (sul2), and aminoglycosides (APH(3'')-Ib, APH(6)-Id), along with the acrEF efflux pump components (acrE, acrF). In contrast, S. flexneri harboured unique genes linked to polymyxin resistance (ugd) and regulatory functions (sdiA, gadW) that were absent in S. boydii. These findings highlight Shigella strains' genomic diversity and antimicrobial resistance potential in livestock-associated environments. Moreover, S. boydii highlights the potential risk of multidrug-resistant bacteria in farming and environmental routes. KEY POINTS: &#x2022; First whole genome study of Shigella from manure and small ruminants in South Africa. &#x2022; Shigella boydii strain carried multiple resistance genes to &#x3b2;-lactams and tetracycline. &#x2022; Multidrug efflux pump gene mdf(A) was detected in 99% of South African Shigella flexneri strains.

Animals↗
PubMed2001

Factors affecting behaviors that address HIV risk among senior secondary school pupils in South Africa.

The purpose of this study was to identify factors affecting HIV risk reduction among senior secondary school pupils in South Africa. The sample included 460 Grade 12, Secondary School pupils whose ages ranged from 16 to 30 years (M = 19.7 yr., SD = 2.5) and who were chosen at random from the total Grade 12 population throughout one region in the Northern Province of South Africa. Measures were of sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioral norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS vulnerability (likelihood to get it) and severity of the illness in the country, and condom use self-efficacy. Bivariate analysis gave positive significant relations among normative beliefs, subjective norms, and attitudes towards condom use as well as HIV/AIDS vulnerability and HIV risk behavior. Regression analysis indicated that for boys, younger age at first vaginal intercourse, less intention for condom use, and HIV/AIDS vulnerability were predictive for HIV/AIDS risk behavior and explained 39% of the variance. It is suggested that these predictors should be included in intervention programs for HIV prevention.

Adolescent↗
PubMed2000

Survey of canine babesiosis in South Africa.

A questionnaire, designed to obtain qualitative information on a number of variables concerning canine babesiosis (biliary fever) in South Africa, was sent to 510 veterinary practices in late 1993. Of the 157 practices that responded, all were presented with cases of babesiosis and most were situated in Gauteng, the Western Cape and KwaZulu-Natal. Apart from the Western Cape, a winter-rainfall region, the prevalence of babesiosis cases in dogs was highest in summer. Most of the respondent practices treated between 1,000 and 5,000 sick dogs that included 100 to 500 babesiosis cases each year. Respondents identified cerebral babesiosis, enterorrhagia, 'red' or haemoconcentrated babesiosis, acute renal failure and pulmonary babesiosis or 'shock lung', amongst others, as the most prevalent forms of complicated ('atypical') babesiosis. Diminazene, imidocarb and trypan blue were the most popular antibabesials. Trypan blue was most often used in shocked patients, whereas diminazene and imidocarb were preferred when there was a high parasitaemia in the absence of shock. At least 19 antibabesial treatment regimens were used in practices. These comprised the use of single doses of antibabesial drugs; split doses with repeat injections, and combined drug variations, some of which are undesirable due to possible sterilisation of Babesia infection or potential toxicity. Side-effects were most commonly associated with imidocarb use. Ninety-six percent of respondents used supportive treatment (e.g. corticosteroids, vitamins and 'liver support') in all cases of babesiosis. The use of blood transfusion as supportive treatment varied according to practice and severity of the case. Most practices never cross-matched blood to be transfused, and transfusion reactions were rare. Diminazene was most frequently incriminated in cases where drug 'resistance' or relapses occurred. Cerebral and 'red' cases resulted in high mortality. Treatment of babesiosis costs the dog-owning public in South Africa more than R20 million each year. Information on the distribution and possible complicating role of Ehrlichia canis was obtained. Development of a vaccine was the first research priority identified.

Animals↗
PubMed2007

Microbicide applicators: understanding design preferences among women in the dominican republic and South Africa.

OBJECTIVES: The objectives of this study were to prioritize applicator design attributes among women in the Dominican Republic and South Africa, and to determine how preferences differed based on sociodemographic variables. GOAL: The goal was to identify acceptable microbicide applicator designs in 2 low-resource settings. STUDY DESIGN: We surveyed 895 women, randomly sampled from clinics in the Dominican Republic (n = 449) and South Africa (n = 446), with questions on sociodemographics, applicator attribute preferences, and price/design tradeoffs. RESULTS: Single-use design was the most valued attribute, and reusable design and low price were the least valued attributes in both populations. Preference for single-use design was associated with concern about reusable applicators spreading germs, secondary or higher education, older age, having children, and perception of moderate to high HIV risk. CONCLUSIONS: Acceptability factors related to microbicide delivery mechanisms should continue to be evaluated among potential microbicide users to directly inform product development and introduction of microbicides.

Administration, Intravaginal↗
PubMed1997

The sword of Damocles: the psychosocial impact of familial spinocerebellar ataxia in South Africa.

A survey was conducted on 30 unaffected individuals from a family with autosomal dominant late onset spinocerebellar ataxia in South Africa. The psychological impact of the disorder on individual lives, risk awareness, attitudes towards affected kin and reproduction were evaluated. Respondents employed various psychological strategies to deal with the threat of developing the disorder. In a comparison of "assigned" risk with "perceived" risk, 80% of unaffected persons reported incorrect perceptions of personal risk status. The disorder had little impact on attitudes concerning reproduction; the majority of individuals at risk wanted more children. These issues need to be addressed in the genetic and predictive testing service for familial ataxia in South Africa.

Adolescent↗
PubMed2002

Suicide by self-immolation in Durban, South Africa: a five-year retrospective review.

Self-immolation is an uncommon method of suicide, and its occurrence in South Africa is thus far unknown. This study aimed to determine the prevalence of self-immolation deaths and to establish a profile of these cases and the circumstances under which this condition occurs. A 5-year (1996-2000) retrospective review at a mortuary in Durban, South Africa, was conducted. Data were obtained from the Department of Forensic Medicine, the Medical Research Council's National Injury Mortality Surveillance System, and police and hospital records. During the study period, there were 12339 nonnatural deaths, of which 696 (5.6%) were suicides. Self-immolation accounted for 69 (0.6%) of all nonnatural deaths and 69 (9.9%) of all suicides. The subjects had a mean age of 31.2 years and were predominantly female (76.8%) and black (81.2%). The mean burn surface area was 63.3%, and the mean injury severity score was 36.9. Accelerant use was documented in 53 (76.8%) of cases, and paraffin was preferred. All cases occurred indoors. The proportion of suicides due to self-immolation in our study is excessive when compared with international studies that report figures between 0.9% and 2.2% of suicides. Additional studies are necessary to further elucidate the reasons for this discrepancy.

Adolescent↗
PubMed1978

Some infectious diseases of wild vervet monkeys (Cercopithecus aethiops pygerythrus) in South Africa.

Our surveys indicate that nearly all batches of vervet monkeys arriving at the National Institute for Virology from various areas of South Africa, are infected with foamy viruses and there is evidence that intra-urterine infection also occurs. Monkeys from certain areas of South Africa are apparently infected with the protozoal parasite Entopolypoides macaci in a sub-clinical state which becomes active when the monkeys are splenectomised. Serological studies indicate that infections with schistosomes, tick-bite fever (Rickettsia conori), chlamydsiae and occasionally by leptospirae, occur in monkeys in the Kruger National Park. Complement fixation tests for antibodies to R. mooseri and R. prowazeki were also sometimes positive; a finding of doubtful importance. There was a high percentage with positive antibody tests to chikungunya virus in a certain age group suggesting that there had been an outbreak of this disease in the Kruger Park in the late summer and autumn of 1976. This coincided with a human outbreak. Large numbers of vervet and baboon sera were tested for antibodies against SA 12 virus, a polyoma virus. A high percentage of baboons but only a small number of monkeys was found to be positive and it is concluded that SA 12 is probably a baboon virus which is occasionally transmitted to monkeys by contact. It is pointed out that these studies only indicate diseases from which monkeys recover and they do not indicate prevalence of severe disease causing grave illness or death.

Animal Population Groups↗
PubMed2002

HIV-1 subtype C reverse transcriptase sequences from drug-naive pregnant women in South Africa.

The HIV-1 reverse transcriptase genes from 37 HIV-1-positive pregnant women attending an antenatal clinical in Soweto, South Africa were sequenced and analyzed for the presence of drug resistance mutations. All women were antiretroviral drug naive, but were being screened as potential participants in clinical trials of antiretroviral drugs aimed at preventing mother-to-child transmission. Sequence analysis revealed that all belonged to HIV-1 subtype C, the predominant subtype among heterosexual populations in South Africa. Twenty-three amino acid loci associated with resistance to zidovudine, lamivudine, didanosine, stavudine, and nevirapine were examined and found not to encode mutations that would confer resistance to these drugs. Polymorphisms at these loci occurred infrequently, with three patients harboring the A98S and V179I polymorphisms. An additional three patients harbored V118I, which can function as an accessory resistance mutation, but in this context is also likely to be a polymorphism. These data show that pregnant women who are candidates for receiving antiretroviral drug therapies do not contain naturally occurring or preexisting drug resistance mutations and that such drug therapies are likely to be highly effective in this setting.

Amino Acid Sequence↗
PubMed2005

Secondary anthropometric data analysis of the National Food Consumption Survey in South Africa: the double burden.

OBJECTIVE: There is an increase in the prevalence of overweight and obesity in children worldwide, including South Africa. We investigated the prevalences of overweight, obesity, and stunting in a current generation of children (ages 12 to 108 mo), which has a high prevalence of stunting, and evaluated the determinants of both nutritional disorders. METHODS: Secondary data analysis of the weight and height measurements of 12- to 108-mo-old children (weighted n = 2200, non-weighted n = 2894) during the 1999 National Food Consumption Survey in South Africa is reported. The body mass index reference percentiles recommended for use in children by the International Obesity Task Force were used to determine the prevalence of overweight and obesity, and the National Center for Health Statistics (NCHS) percentiles were used to determine the prevalence of stunting. RESULTS: Nationally, the prevalence of stunting (height-for-age < or = -2 standard deviations, NCHS 50th percentile) in these children was 19.3% (95% confidence interval [CI] = 17.49 to 21.16) and was highest in 1- to 3-y-old children (24.4%) and in children of farm workers on commercial farms (25.6%). The prevalence of combined overweight and obesity (body mass index > or = 25 kg/m(2) in 17.1%, 95% CI = 15.00 to 19.23) at the national level was nearly as high as that for stunting. Further, the types of determinants for stunting and overweight were generally similar (although directionally opposite in degree of risk conferred) and included type of housing, type of toilet in the home, fuel used in cooking, presence of a refrigerator or stove, presence of a television in the house, educational level of the caregiver, and maternal education level. An example of the directionally opposite degree of risk is exemplified by the use of paraffin as a fuel being protective against being overweight (odds ratio = 0.78, 95% CI = 0.63 to 0.97) but predictive of an increased risk for stunting (odds ratio = 1.24, 95% CI = 1.04 to 1.48). Stunting itself conferred an increased risk (odds ratio = 1.80, 95% CI = 1.48 to 2.20) of being overweight. CONCLUSION: Certain defined determinants appear to play important roles in children's nutritional outcomes in relation to stunting and to overweight and obesity.

Anthropometry↗
PubMed2000

Collection of free-living nymphs and adults of Amblyomma hebraeum (Acari: Ixodidae) with pheromone/carbon dioxide traps at 5 different ecological sites in heartwater endemic regions of South Africa.

The capture of free-living adults and nymphs of Amblyomma hebraeum, the main vector of heartwater in domestic and wild ruminants in South Africa, by means of attraction-aggregation-attachment-pheromone/carbon dioxide traps at five endemic localities in South Africa is described. Although the traps were used successfully at each of the localities, no determination of their efficiency in relation to the actual abundance of ticks at a particular site was made. This study confirmed that the traps could be used in a variety of ecological areas to locate populations of free-living adult A. hebraeum.

Animals↗