http://hdl.handle.net/10386/186 Sun, 19 May 2013 10:36:28 GMT 2013-05-19T10:36:28Z http://hdl.handle.net/10386/781 Title: Factors associated with pulmonary tuberculosis treatment outcomes at Potchefstroom Prison in North West Province, South Africa Authors: Mnisi, Joseph Thabo Abstract: BACKGROUND AND OBJECTIVE Tuberculosis remains an important curable disease particularly in the developing world. One third of the world's population is infected with T8 and new infections are occurring at a rate of about one per second(Tuberculosis Wikipedia Encyclopedia 2009).The distribution globally is not uniform with eighty percent of cases in Africa and Asia(Tuberculosis Wikipedia Encyclopedia 2009). Treatment is challenging because it requires compliance to long courses of multiple antibiotics. WHO highlights the global failure of health service providers to deal with the burden of tuberculosis (Fourie et aI1999). The researcher observed that socio-economic factors, political and intrapersonal aspects associated with T8 infection might as well be important to the treatment outcome. It was therefore important to explore factors that could be associated with treatment outcomes in the prison environment where the full impact of these factors could be found. This study was conducted at Potchefstroom prison in North Westprovince of South Africa. METHODS A quantitative cross-sectional study was done. A record review of all T8 patients in Potchefstroom prison who initiated their treatment in 2007 and ending their treatment up to 2010 was conducted. Data was recorded on data collection sheet and results were then analyzed. Descriptive analysis was done to provide frequencies, mean and standard deviation. Measures of association between characteristics and treatment outcome using odds ratio was done. RESULTS 202 T8 patients in this prison had T8 during the period covered by the study. The age group distribution of the patients shows that majority, 142(70.3%) belong to the age group 21- 37 years while those aged 38 - 53 years was 48(23.8%) and their mean age was 33.7yrs. There were 197(97.5%) male and 4(2.0%) female and 1 (0.5%) no records. Of these, therewere 92(45.5%) patients cured 4 (2%) death, 1 (0.5%) treatment failure and 102 recorded as other outcomes belonging to the transferred and treatment interruption cluster. Factors compared with these outcomes were, age, gender, initial body weight, level of education, treatment initiation time, regimen type, social support, co morbidities, smoking, application of DOT ant the type of T8. Factors that were significantly associated with favorable outcomes were occasional visits providing some social support (39.4%, OR 3.78, 95% CI1.25-11.54), DOT application (37.4%, OR 3.99, 95% CI 2.35-11.23), young age (32.6% OR 3.14, 95% CI 2.1-5.3) and Regimen 1 (34.0%, OR 1.5, 95% CI0.11-12.61) Social habits like smoking were significantly higher in patients with other treatment outcome(OR=1.56, 95% CI=1.92 to 2.05), other factors found to be aligned to negative outcomes but lacking statistical significance were extra-pulmonary tuberculosis, non application of DOT, regimens other than regimen 1, and lack of social visits. Factors like co-morbidity and gender were found not to be significantly associated with any treatment outcome because there was no point of difference in the association of different grouping in these categories with particular outcome. CONCLUSION Many factors could be associated with treatment outcomes to some varying degree, but only significant factors explored in this study were considered important. Factors that were ultimately identified as important in determining treatment outcome were age, smoking status, social support, DOT and regimen type. These were factors that were found to be contributory to the pathology of TB in many other studies and which are amenable to interventions that would improve the outcomes. Description: Thesis (M Med(Family Medicine)) -- University of Limpopo, 2010. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/10386/781 2010-01-01T00:00:00Z http://hdl.handle.net/10386/780 Title: The Profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Dr Congo Authors: Pepe, Banza Kalenga Abstract: Background In the Vanga Health Zone, diabetic patients have idea that diabetes is due to witchcraft, which idea can interfere with the prevention and management of their disease. The purpose of this study was to determine the profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Democratic Republic of Congo (DR Congo). Methods A cross-sectional study was designed with use of a questionnaire to a systematic sample of type 2 diabetic patients attending the diabetic clinic of Vanga hospital for at least six months and resident at Vanga health zone. Results Only 2.1 % of the participants believe in a scientific cause for diabetes; 53.5 % of them do not think that their disease is due to the fact that they crossed over a path where some ritual was performed and, 89.2 % of the participants believe that God deserted the person who suffered from diabetes and expect that prayer will rectify the disease. The majority of participants (65.6 %) had poor glycaemic control. Correlation analysis has shown that glycaemia level was not significantly associated with sociodemographic characteristics or health belief factors. Conclusion The majority of patients at the Vanga diabetic clinic have a greater need for management strategies to improve their glycaemic control. Keywords: type 2 diabetes mellitus, health beliefs, knowledge, sub-Saharan Africa, rural Description: Thesis (Family Medicine)) -- University of Limpopo, 2010. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/10386/780 2010-01-01T00:00:00Z http://hdl.handle.net/10386/779 Title: Prevalence and characteristics of adolescent HIV/AIDS cases seen at the wellness clinic of Bernice Samuel Hospital in Delmas, Mpumalanga (2009) Authors: Oladejo, Olatayo Wasiu Abstract: Background. The study was aimed at showing the prevalence, clinical and demographic characteristics of HIV positive adolescents attending the Wellness clinic of the Bernice Samuel Hospital in Delmas. Design. The study was a retrospective, cross-sectional study. Methods. A non-probability sampling (criterion sampling) was used. All patients between the ages of 11 years to 19 years who are registered at the Wellness clinic of Bernice Samuel Hospital in Delmas for the period 1 January 2009 to 31 December 2009 were taken. The variables studied included Prevalence, Demographic variables (gender, age group, population group, marital and employment status as well as Proximity to ART site) and Clinical variables(Viralload at presentation, CD4 count, Hemoglobin, associated sexually transmitted disease, associated health problems pre and post HAART, antiretroviral regimen, WHO staging). Results. The study showed a great disparity between the total number of adolescents picked up by VCT in the community and those registered for follow up care at the Hospital's Wellness clinic (Clinic prevalence 2.3% versus community prevalence 3.8%). Most of the patients were females, evenly distributed in early and late adolescence, were scholars presenting at an advanced stage of the disease despite an easy access to health care. Common health problems encountered in these patients were oral Candidiasis, malnutrition, pneumonia, and diarrheal illness. The commonest adverse reactions to HAAR T were gastrointestinal symptoms and hepatotoxicity. Retention on the ARV treatment program was good but there was an unacceptable delay in initiating HAART. Death was the commonest cause of loss to follow up. Conclusion. Adolescent HIV / AIDS remains a problem in the Delmas municipality even though prevalence appears to be low. The cause of late presentation in the wellness clinic despite good access will need to be investigated and rectified. Description: Thesis (Family Medicine)) -- University of Limpopo, 2010. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/10386/779 2010-01-01T00:00:00Z http://hdl.handle.net/10386/701 Title: Reasons patients leave their provided health care service to attend Karen Park Clinic, north of Pretoria Authors: Masango-Makgobela, Agnes Tola Abstract: Background: Many patients move from one healthcare provider to another, disturbing the continuity of holistic patient care. Objectives: The aim of this study is; to investigate the reasons why patients leave their nearest clinic, and to determine if these patients are able to use the provided care when they need to. Methods: A cross-sectional, quantitative study was conducted during the winter of 2010. Questionnaires were given to 350 patients attending Karen Park Clinic. Patients completed the questionnaires in the presence of the researcher, who was able to assist where needed. Variables addressed in the questionnaire included: place where they stay; if they visited their nearest clinic; what services there are at their nearest clinic; would they go back to their nearest clinic and if not, what would be the reasons. Results: The majority of respondents stayed in Soshanguve, 153 (43.7%), Mabopane 92(26.3%)Garankuwa, 29(8.3%)and Hebron 20(5.7%), Most ofthe respondents were females 271(77.4%), with 177 (50.6%)aged between 26 and45years. Eighty percent of patients indicated that they visited their nearest clinic and 191(54.6%) said that they will not return to that clinic. The reasons for not returning to the nearest clinic were: - no medication, 39(11.1%); long queues, 59(16.9%); rude staff, 59(16.9%); long waiting time to be helped, 88(25.1%) and other, 63(18.0%). Conclusion: The researcher found that many patients, who first attended their nearest clinic, opted not to return. Reducing long waiting times and long queues at a primary health care centre can be achieved. Satisfied health care providers would provide quality service to patients. Training courses for management committee members could lead to improving the health center's management and patients could be redirected to their nearest clinic by giving them referrals or transfer letters. Purchasing enough medicine will reduce the problem of no medication and increase the capability of the health center. Staff should receive training about health care practices, to reduce the rude behaviors that drive patients away. Description: Thesis (M Med (Family Medicine)) -- University of Limpopo, 2010. Fri, 01 Jan 2010 00:00:00 GMT http://hdl.handle.net/10386/701 2010-01-01T00:00:00Z