Tag: nevin manimala

S Afr Fam Pract (2004). 2025 Mar 21;67(1):e1-e7. doi: 10.4102/safp.v67i1.6010.

ABSTRACT

BACKGROUND: Human immunodeficiency viruses (HIV) and/or acquired immunodeficiency syndrome remains a significant global health issue, affecting millions of individuals worldwide. Medical male circumcision (MMC) demonstrated effectiveness in decreasing the spread of HIV, more specifically through heterosexual contact with HIV-positive partners. Studies have shown a correlation between male circumcision and lower HIV prevalence, especially in regions where circumcision is a cultural practice. The purpose of the study was to determine the knowledge and attitudes of men utilising the MMC services regarding circumcision.

METHODS: A cross-sectional study was conducted at a community health centre involving 164 male participants aged 18 years and above using a self-administered questionnaire. Descriptive and inferential statistics were used to determine means, frequencies and associations between knowledge and attitudes of men regarding male medical circumcision.

RESULTS: The median age of men seeking MMC services was 30 years, with hygiene cited as the primary reason by 88.4% of them. In addition, a majority (92%) were mindful of the advantages of circumcision in terms of lowering the risk of sexually transmitted infections and penile cancer (90%).

CONCLUSION: Hygiene emerged as the primary reason for seeking MMC, contrasting with other studies where cultural and religious factors were more common. Despite significant knowledge levels regarding MMC’s health benefits, the overall attitudes towards the procedure were predominantly negative.Contribution: The study highlights a unique factor influencing the decision to undergo MMC in a community health setting and awareness of its health benefits.

PMID:40171714 | DOI:10.4102/safp.v67i1.6010

Curationis. 2025 Mar 25;48(1):e1-e9. doi: 10.4102/curationis.v48i1.2653.

ABSTRACT

BACKGROUND: The South African public is not satisfied with the level of healthcare rendered by South African health institutions, particularly in Gauteng province; this is evidenced by the concerns raised by the South African Health Ombudsman, who, as of 2021, received more than 2000 complaints from the public, of which 40% were from Gauteng province. This is supported by South African Nursing Council (SANC)’s unprofessional report, which reflected the increase in poor nursing care cases.

OBJECTIVES: The objectives of the study were to identify the factors contributing to the quality of nursing care at the provincial hospitals of Gauteng province and to make recommendations for improving the quality of nursing care in hospitals.

METHOD: The study utilised an exploratory descriptive qualitative design. The data were analysed following Colaizzi’s steps of data analysis, during which 4 themes and 9 sub-themes emerged. The study population consisted of registered professional nurses working in the two hospitals. The sample consisted of 12 registered professional nurses.

RESULTS: The study identified three positive factors, namely, nursing as a calling, supervision rounds and staff appreciation. Six negative factors that contribute to the quality of nursing care were identified as the lack of human and material resources, administrative challenges, unsupportive management, nurse-related factors, attitudes of patients, and private versus public health institutions.

CONCLUSION: The study revealed the positive factors that promote the quality of nursing care. The negative factors affecting the quality of nursing care were found to be more than the positive factors.Contribution: The study presented factors affecting the quality of nursing care and makes recommendations that can be utilised as basis for improving the quality of nursing care. The study findings and recommendations can be used to develop programmes to support nurses to provide dignified and quality patient care in the hospital.

PMID:40171707 | DOI:10.4102/curationis.v48i1.2653

Acta Oncol. 2025 Apr 2;64:499-506. doi: 10.2340/1651-226X.2025.42557.

ABSTRACT

BACKGROUND AND PURPOSE: Health literacy is defined as the ability to find, understand and use health information for informed decision. The role of health literacy in treatment decisions and outcome remains largely unexplored. This study sought out to assess the effect of individual health literacy on overall survival (OS) in cancer patients in Ostrobothnia.

MATERIAL AND METHODS: The present study is a follow-up of a cross-sectional survey study performed during December 2021 and March 2022. The survey assessed socioeconomic factors, lifestyle factors and self-reported health literacy. The follow-up included data on recorded death, cause of death, performance status (PS), clinical frailty scale, Charlson comorbidity index and body mass index. The sample size for this study was 400 participants, and any participant with a malignancy was eligible for the study.

RESULTS: Low health literacy was associated with increased risk of death. The disparity remained after adjustments for age, sex, comorbidities, PS, stage and hazard ratios (HR) = 1.47 (1.01-2.14). After adjustments for lifestyle patterns, the disparity remained, HR = 1.49 (1.03-2.17). The difference diminished after adjustments for cancer types. The median OS was 3.6 months longer for those with medium-high health literacy than those with low health literacy.

INTERPRETATION: The results indicated health literacy having a direct, clinically significant, effect on OS, which is likely not explained by differences in cancer entity alone. Future studies should focus on assessing whether an intervention aiming to improve health literacy may improve overall cancer survival.

PMID:40171705 | DOI:10.2340/1651-226X.2025.42557

Afr J Prim Health Care Fam Med. 2025 Mar 12;17(1):e1-e12. doi: 10.4102/phcfm.v17i1.4718.

ABSTRACT

BACKGROUND: The continuum of care (CoC) in maternal and neonatal services among women in Ethiopia was low because of individual and cultural barriers.

AIM: This study aims to identify factors that hindered the utilisation of the CoC services.

SETTING: The study took place in the Assosa Zone of north-western Ethiopia.

METHODS: A qualitative study using audio-taped individual interviews was conducted. A total of 52 study participants were purposefully recruited from the Assosa Zone. Thematic analysis was employed to identify major themes and categories from the transcripts.

RESULTS: Findings revealed the economic situation of women as the underlying barrier to women accessing and utilising maternal and neonatal CoC services. Presumably, high transport and medical costs and the inability to pay the raised costs were drivers to discontinuity of the CoC of maternal and neonatal services. Other barriers to utilisation of CoC services were found to be workload in the households, secreting pregnancy, traditional beliefs, husbands’ attitude and religion, awareness gaps in pregnancy, and maternal and neonatal care. These factors are thus regarded as important barriers to the utilisation of continuity of care in maternal and neonatal services in Ethiopia.

CONCLUSION: Moreover, economic, cultural and religious factors, maternal awareness and husbands featured as significant barriers to the utilisation of maternal and neonatal CoC services in Ethiopia.Contribution: The findings revealed the economic situation of women as a barrier to the CoC in maternal and neonatal services utilisation, manifesting itself in unaffordable transport and medication user fees.

PMID:40171698 | DOI:10.4102/phcfm.v17i1.4718

Afr J Prim Health Care Fam Med. 2025 Mar 31;17(1):e1-e7. doi: 10.4102/phcfm.v17i1.4721.

ABSTRACT

BACKGROUND: Worldwide, the proportion of hypertensive patients with controlled blood pressure is poor. Knowledge on hypertension has been recognised as a major determinant of uncontrolled hypertension.

AIM: This study aimed to determine factors associated with knowledge and control of hypertension among hypertensive patients in Kimpese Health Zone, in the Democratic Republic of the Congo (DRC).

SETTING: Six health facilities of the Kimpese Health Zone were selected.

METHODS: This study was an analytical cross-sectional study from May 2021 to December 2021. Information on socio-demographic characteristics, clinical data and knowledge on hypertension was collected. Factors associated with knowledge and control of hypertension were determined using logistic regression analysis.

RESULTS: A total of 301 participants with a sex ratio of 1:3 (F M) and a mean age of 60.5 ± 12.1 years were included in the study. Poor knowledge on hypertension (79.1%) and a treatment failure (84.3%) were common. Low educational level (p = 0.024; adjusted odds ratio [aOR] = 2.64 [1.72-3.73]), rural residence (p = 0.02; aOR = 3.34 [1.24-8.52]) and a lack of information by a health professional (physician or nurse) (p ≤ 0.001; aOR = 3.34 [1.24-8.52]) were significantly associated with poor knowledge. In addition, high cardiovascular risk (p = 0.009; aOR = 2.75 [1.29-5.84]), subclinical atherosclerosis (p = 0.000, AOR = 9.26 [3.54-24.23]) and absence of knowledge on hypertension (p = 0.042, AOR = 1.96 [1.49-2.23]) were significantly associated with uncontrolled hypertension.

CONCLUSION: There was propensity of uncontrolled hypertension and poor knowledge among the study participants. Poor socio-demographic conditions and a lack of accurate information on hypertension increased odds of poor knowledge of the disease. In addition, insufficient knowledge on hypertension and comorbidities were associated with uncontrolled hypertension.Contribution: Education on hypertension and screening; managing comorbidities in integrating approach to non-communicable diseases are key components of managing hypertension in our setting to improve health outcomes.

PMID:40171697 | DOI:10.4102/phcfm.v17i1.4721

Afr J Prim Health Care Fam Med. 2025 Mar 25;17(1):e1-e7. doi: 10.4102/phcfm.v17i1.4834.

ABSTRACT

BACKGROUND: Rapid urbanisation in low- and middle-income countries (LMICs) has intensified the double burden of malnutrition, where undernutrition and overnutrition coexist in the same populationAim: This study aimed to examine the point prevalence rate and risk factors of the double burden of malnutrition among adults in urban Zimbabwe.

SETTING: The study was conducted in Zimbabwe’s two metropolitan provinces (Harare and Bulawayo).

METHODS: A cross-sectional study of 348 urban adults explored associations between dietary intake, socio-demographics and anthropometrics using means, frequencies, and logistic regression.

RESULTS: Obesity prevalence was 23.6%, and underweight prevalence was 8.6%. Men had higher odds of being underweight than women (Adjusted Odds Ratio 2.30, 95% CI 1.20-4.41), while high household income increased the odds of obesity (Adjusted Odds Ratio 2.90, 95% CI 1.47-5.60). A fruit and vegetable-rich diet reduced the odds of obesity by 47% (Adjusted Odds Ratio 0.53, 95% CI 0.26-0.89), whereas a diet dominated by staples and sugary foods increased the risk of obesity.

CONCLUSION: Obesity and underweight were common among urban adults in Zimbabwe, where both undernutrition and overnutrition pose significant health risks. Public health interventions in LMICs should broaden their focus to address adult malnutrition and its contribution to diet-related non-communicable diseases (NCDs).Contribution: The double burden of malnutrition underscores an urgent need for comprehensive public health strategies in LMICs. Efforts should move beyond childhood undernutrition to address the entire spectrum of malnutrition. Tackling these challenges holistically will be key to mitigating undernutrition, curbing rising obesity rates, and, in turn, reversing the tide of diet-related NCDs.

PMID:40171696 | DOI:10.4102/phcfm.v17i1.4834

Afr J Prim Health Care Fam Med. 2025 Mar 20;17(1):e1-e10. doi: 10.4102/phcfm.v17i1.4781.

ABSTRACT

BACKGROUND: Preoperative assessment clinics play a critical role in identifying, evaluating and mitigating perioperative risks. Despite global data highlighting the importance of preoperative risk factors on surgical outcomes, there remains limited information on their impact on post-operative length of stay (LOS) in South African contexts.

AIM: This study aimed to describe the demographic and clinical profiles of patients referred to a preoperative clinic as well as factors associated with post-operative extended LOS.

SETTING: The preoperative clinic is based in the city of Johannesburg in South Africa.

METHODS: This was a prospective cohort study conducted between 2021 and 2022 at a private clinic in patients undergoing non-cardiac surgery. Data on demographics, co-morbidities, surgical procedures and clinical outcomes were collected. Statistical analysis was performed to assess relationships between preoperative risk factors, including ASA grading, Revised Cardiac Risk Index (RCRI), estimated glomerular filtration rate, diabetes mellitus, age, obesity and LOS.

RESULTS: A total of 214 patients were assessed, of which 75.7% were female, with a median age of 62.5 years. Common co-morbidities included hypertension (59.3%) and obesity (55%). The median LOS was 3.5 days, with 47.2% of patients staying more than 3 days post-operatively. Knee (33.2%) and hip surgeries (21%) were the most common procedures. A significant association was found between longer LOS and RCRI score ≥ 1 (p = 0.007), renal dysfunction in knee surgery patients (p = 0.027) and age in patients undergoing hip surgery (p = 0.049).

CONCLUSION: Findings note the need for targeted intereventions in preoperative care to reduce LOS, particularly for high-risk patients.Contribution: This study highlights the fact that preoperative information may play a significant role in patient’s outcomes post surgery. Further research is needed to validate these results across broader healthcare settings.

PMID:40171694 | DOI:10.4102/phcfm.v17i1.4781

Afr J Prim Health Care Fam Med. 2025 Mar 14;17(1):e1-e10. doi: 10.4102/phcfm.v17i1.4696.

ABSTRACT

BACKGROUND: Diabetes is one of the major non-communicable diseases. Diabetes self-management has been identified as a key strategy to reduce complications and to improve health outcomes.

AIM: This study aimed to investigate the diabetes self-management knowledge, attitude and practices among people with type-2 diabetes in Ghana.

SETTING: Two clinics for diabetes patients in the Ho municipality of Ghana were selected to conduct the study.

METHODS: An outpatient cross-sectional survey was conducted using a 57-item researcher-administered questionnaire based on the Information, Motivation, Behaviours Model adopted for Diabetes. A total of 321 patients with type 2 diabetes were randomly selected from the two outpatient clinics for diabetes in Ho, Ghana. Data were analysed using descriptive statistics and multiple linear regression modules were conducted to determine the predictors of self-management practices. Significance was set at p 0.05.

RESULTS: The average score for knowledge was 11.37/24 ± 3.40 or 47%, indicating poor levels of diabetes self-management knowledge. Moderately positive attitudes were found (2.83/5 ± 1.57) [95% CI -1.86 to -3.80] with poor self-management practices with a median of 3.00 per week (maximum 5.20, minimum 0.60 per week). Knowledge explained 20% of variation in self-management practice.

CONCLUSION: The findings from this study show an overall deficit in knowledge of diabetes with related low self-management practice. This suggests the need for robust self-management education programmes to improve access to diabetes self-management-related information.Contribution: This study highlights the important knowledge of diabetes in self-management.

PMID:40171692 | DOI:10.4102/phcfm.v17i1.4696

Afr J Prim Health Care Fam Med. 2025 Mar 12;17(1):e1-e8. doi: 10.4102/phcfm.v17i1.4773.

ABSTRACT

BACKGROUND: An ongoing challenge within the field of undernutrition is to identify children at risk.

AIM: The objective of this study was to investigate whether children who are living in households inhabiting a household member with a life-limiting illness are at risk of undernutrition.

SETTING: A comparative cross-sectional study was performed in Uganda.

METHODS: We collected anthropometric data on children under the age of five and information on household dietary diversity, food security and healthcare barriers. Study participants for the hypothesised high-risk group were recruited within households receiving home-based palliative care. The comparison group included neighbouring households.

RESULTS: Data collection from 145 paired households was performed from April to July 2021. There was no statistically significant difference in prevalence of undernutrition. For all continuous nutrition indicators there was a trend towards less undernutrition in the hypothesised high-risk group than in the comparison group. We found lower overall prevalence of acute malnutrition than expected. The hypothesised high-risk group was associated with higher food insecurity than the comparison group.

CONCLUSION: Lower overall acute malnutrition than expected may be because of the season variability. Stunting was higher than expected in both groups, which may suggest season variability in undernutrition. The results suggest a protective effect of receiving home-based palliative care on child nutritional status.Contribution: The study did not show a risk of child undernutrition in households inhabiting a household member with life-limiting illness. Future research may identify key elements responsible for the potential protective effects of home-based palliative care on child undernutrition.

PMID:40171691 | DOI:10.4102/phcfm.v17i1.4773

Afr J Prim Health Care Fam Med. 2025 Mar 26;17(1):e1-e6. doi: 10.4102/phcfm.v17i1.4749.

ABSTRACT

BACKGROUND: Psychological distress (PD) is a prevalent concern among undergraduate health science students globally. Despite this, data specific to Uganda is limited.

AIM: This study assessed the prevalence of PD among undergraduate health sciences students in Uganda.

METHODS: We obtained data on the psychological distress burden using self-administered DASS-21 questionnaires. Data were analysed using SPSS version 20.

RESULTS: We enrolled 398 participants, of whom 217 (54.5%) were males. The median age of the participants was 22 years (interquartile range [IQR], 21 to 24). Of the participants, more than half (57%) had moderate to severe symptoms of anxiety. Nearly half of them (42%) reported moderate to severe symptoms of depression, while 26% of the students had moderate to severe symptoms of stress.

LESSONS LEARNT: This study highlights significant psychological distress among health science students at Makerere University, with high levels of anxiety, depression and stress. It emphasises the need for improved mental health support in academic settings, aligning with the African Journal of Primary Health Care Family Medicine’s focus on contextual healthcare challenges.

PMID:40171688 | DOI:10.4102/phcfm.v17i1.4749