scholarly journals Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa’s Eastern Cape province

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sikhumbuzo A. Mabunda ◽  
Khuthala Sigovana ◽  
Wezile Chitha ◽  
Teke Apalata ◽  
Sibusiso Nomatshila
Keyword(s):  
Primary Care ◽  
Antenatal Care ◽  
Rural Areas ◽  
Statistical Significance ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Care Facilities ◽  
Incident Cases

Abstract Background To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa. Methods A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance. Results A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2–43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42–141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value< 0.0001). Conclusion Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.

scholarly journals Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa's Eastern Cape province.

2021 ◽  
Author(s):  
Sikhumbuzo A Mabunda ◽  
Khuthala Sigovana ◽  
Wezile Chitha ◽  
Teke Apalata ◽  
Sibusiso Nomatshila
Keyword(s):  
Primary Care ◽  
Antenatal Care ◽  
Statistical Significance ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
P Value ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Care Facilities ◽  
Incident Cases

Abstract Background: To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa.Methods: A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance.Results: A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2 – 43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42-141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value<0.0001).Conclusion: Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.

scholarly journals Socio-demographic associations of HIV among women attending antenatal care in selected rural primary care facilities in South Africa's Eastern Cape province.

2020 ◽  
Author(s):  
Sikhumbuzo A Mabunda ◽  
Khuthala Sigovana ◽  
Wezile Chitha ◽  
Teke Apalata ◽  
Sibusiso Nomatshila
Keyword(s):  
Primary Care ◽  
Antenatal Care ◽  
Statistical Significance ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
P Value ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Care Facilities ◽  
Incident Cases

Abstract Background: To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa. Methods: A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance. Results: A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2 – 43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42-141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29 years, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value<0.0001). Conclusion: Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.

scholarly journals Socio-demographic associations of HIV among antenatal care attendees in selected rural primary care facilities in South Africa's Eastern Cape province

2020 ◽  
Author(s):  
Sikhumbuzo A Mabunda ◽  
Khuthala Sigovana ◽  
Wezile Chitha ◽  
Teke Apalata ◽  
Sibusiso Nomatshila
Keyword(s):  
Primary Care ◽  
Antenatal Care ◽  
Rural Areas ◽  
Statistical Significance ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
P Value ◽  
Cross Sectional ◽  
Care Facilities

Abstract Background To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. There is, however, literature paucity of HIV studies focusing on women attending antenatal care in rural areas in South Africa. Methods A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p ≤ 0.05 for statistical significance. Results A total of 343 participants were recruited. The antenatal HIV prevalence was 38.2% (95%CI: 33.2–43.9). Participants older than 40 years were 4.6 times significantly more likely to be HIV positive compared to teenagers (p-value = 0.019). Furthermore, multiparous, unemployed and employed participants, were significantly associated with 40%, 60% and 70% higher antenatal HIV prevalences respectively when compared to primigravidas or tertiary students (p-value < 0.0001). Conclusion Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high and is increasing in this population, coupled with no spousal attendance in antenatal care and poor condom compliance. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.

scholarly journals Barriers to the Implementation of the HIV Universal Test and Treat Strategy in Selected Primary Care Facilities in South Africa’s Eastern Cape Province

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Onke R. Mnyaka ◽  
Sikhumbuzo A. Mabunda ◽  
Wezile W. Chitha ◽  
Sibusiso C. Nomatshila ◽  
Xolelwa Ntlongweni
Keyword(s):  
Primary Care ◽  
Statistical Significance ◽  
P Value ◽  
Successful Implementation ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Test And Treat ◽  
Universal Test ◽  
Universal Test And Treat ◽  
Care Facilities

Background: The South African government implemented the Universal Test and Treat (UTT) approach to treating HIV in the second half of 2016. As part of a contribution to the successful implementation of UTT, this study looked at barriers to implementation of UTT emanating from weaknesses of the health system in 2 Community Health Centers in South Africa’s Eastern Cape Province. Methods: This was a quantitative cross-sectional design which had both descriptive and analytical components. Convenience sampling was used to select and recruit 2 primary care facilities and 30 nurses. Self-administered questionnaires were used to solicit data from facility managers and nurses. In addition, a record review was used to access 6 months’ data for the period 1 October 2017 to 31 March 2018. Data were analyzed using Stata 14.1. Categorical data were presented using frequency and contingency tables. The 95% confidence interval (95% CI) is used for the precision of estimates and the P-value of statistical significance is P < .05. Results: Facilities were found to have poor leadership and governance; human resource challenges that include shortages, lack of skills and lack of developmental support; poorly resourced service delivery platforms and poor information management. Of the three 90-90-90 targets, health facilities only satisfactorily achieved the second 90 of initiating all who test positive for HIV within a week (93.1% or n = 288/307). Conclusions: This study has been able to identify potential barriers to the implementation of the UTT strategy at the selected facilities including the lack of structured programs in place to monitor performance of healthcare staff, knowledge gaps, and a lack of good clinical governance practices as evidenced by the lack of customized protocols and Standard Operating Procedures.

scholarly journals Experiences and guidelines for footcare practices of patients witli diabetes mellitus

Curationis ◽  
2003 ◽  
Vol 26 (1) ◽  
Author(s):  
P. Matwa ◽  
M. M. Chabeli ◽  
M. Muller ◽  
N. S. Levitt
Keyword(s):  
Diabetes Mellitus ◽  
Lower Limb ◽  
Rural Areas ◽  
Self Management ◽  
Diabetic Patients ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
The Poor ◽  
Patients With Diabetes ◽  
Poor Infrastructure

The former Transkei is a predominantly rural region of the Eastern Cape Province. The poor infrastructure in this area results in inaccessibility of the available health services. The majority is ill equipped to deliver optimum diabetes care. There is an increase of lower limb amputations and lack of knowledge among patients with diabetes mellitus in the former Transkei. These complications can be prevented by patient education on self-management and appropriate footcare procedures. This qualitative study was conducted to explore and describe the experiences and footcare practices of diabetic patients who live in the rural areas of Transkei.

scholarly journals Accessing antiretroviral therapy for children: Caregivers' voices

2016 ◽  
Vol 21 ◽  
pp. 331-338
Author(s):  
Margaret Williams ◽  
Dalena R.M. Van Rooyen ◽  
Esmeralda J. Ricks
Keyword(s):  
Antiretroviral Therapy ◽  
Tertiary Care ◽  
Scale Up ◽  
Target Population ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Hiv Positive ◽  
Eastern Cape ◽  
Care Facilities ◽  
Sub Saharan

Despite efforts to scale up access to antiretroviral therapy (ART), particularly at primary health care (PHC) facilities, antiretroviral therapy (ART) continues to be out of reach formany human immunodeficiency virus (HIV)-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care) facilities in Nelson Mandela Bay (NMB) in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of indepth individual interviews, which were thematically analysed. Guba's model was usedto ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIV positive children.

scholarly journals Known HIV status among adolescent women attending antenatal care services in Eswatini, Ethiopia and Mozambique

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Joel Njah ◽  
Mary Ann Chiasson ◽  
William Reidy
Keyword(s):  
Antenatal Care ◽  
Older Women ◽  
Sexual And Reproductive Health ◽  
Age Groups ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Hiv Status ◽  
Pregnant Adolescents ◽  
Women Living With Hiv ◽  
Living With Hiv

Abstract Background Antenatal care (ANC) clinics remain important entry points to HIV care for pregnant women living with HIV—including adolescents. Prior knowledge of their HIV status at ANC enrollment is crucial to providing services for prevention of mother-to-child transmission (PMTCT) of HIV. We examined known HIV status of pregnant adolescents and women in other age groups at ANC enrollment. Methods A descriptive study of routinely reported PMTCT data from 419 facilities in Eswatini, Ethiopia, and Mozambique, from January through December 2018 was conducted. We assessed knowledge of HIV status by country for three age groups: adolescents aged 15–19 years, young women aged 20–24 years, and older women aged 25–49 years. We report HIV prevalence and proportions of known and newly diagnosed HIV infections in women, by age group and country. The data were summarized by frequencies and proportions, including their 95% confidence intervals. Results Among the facilities examined, 52 (12.4%) were in Eswatini, 63 (15.0%) in Ethiopia, and 304 (72.6%) in Mozambique. Across three countries, 488,121 women attended a first ANC visit and 23,917 (4.9%) were HIV-positive. Adolescents constituted 22% of all ANC attendees, whereas young and older women represented 33% and 45%, respectively. HIV prevalence was lowest among adolescents than in other age groups in Eswatini (adolescents 11.9%, young 24.2% and older 47.3%), but comparable to young women in Ethiopia (adolescents 1.6%, young 1.6% and older 2.2%) and Mozambique (adolescents 2.5%, young 2.5% and older 5.8%), However, in each of the three countries, lower proportions of adolescents knew their HIV-positive status before ANC enrollment compared to other age groups: in Eswatini (adolescents 51.3%, young 59.9% and older 79.2%), in Ethiopia (adolescents 42.9%, young 63.7% and older 75.2%), and in Mozambique (adolescents 16.4%, young 33.2% and older 45.6%). Conclusion Overall, adolescents made up nearly one-quarter of the women examined and had the least knowledge of their HIV status at ANC enrollment. Their HIV prevalence and known HIV-positive status varied widely across the countries examined. Adolescent-friendly sexual and reproductive health, and PMTCT services, before pregnancy, are needed to improve knowledge of HIV status and support pregnant adolescents and their infants. Plain English summary Antenatal care (ANC) clinics are important for HIV testing of pregnant adolescents, who may not know their HIV-positive status at the first ANC visit. We describe data on pregnant adolescents and women in other age groups in ANC services to examine their prior HIV status at ANC enrollment across three African countries. We examined data from 419 PMTCT sites in Eswatini, Ethiopia, and Mozambique from January-December 2018, to evaluate HIV testing results for adolescents, young and older women aged 15–19, 20–24 and 25–49 years, respectively. We report the number of women living with HIV and the proportions of known and newly identified women living with HIV, by age-group and country. Across three countries, 488,121 women attended ANC and 23,917 (4.9%) were living with HIV. Adolescents constituted 22% of all ANC attendees, whereas young and older women represented 33% and 45%, respectively. HIV prevalence in each country compared to other age groups was lowest and varied among adolescents from 11.9% in Eswatini, to 1.6% in Ethiopia and to 2.5% in Mozambique. Also, fewer adolescents knew their HIV-positive status before ANC enrollment compared to young and older women from 51.3% in Eswatini, 42.9% in Ethiopia to only 16.4% in Mozambique. Pregnant adolescents made up nearly one-quarter of all ANC attendees; a majority of them had no previously known HIV-positive status. Adolescent-friendly, sexual and reproductive health services, before pregnancy and in PMTCT services, are needed to support pregnant adolescents and their infants.

scholarly journals Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Teke Apalata ◽  
Sandisiwe Nojaholo ◽  
Ikanyeng D. Seipone ◽  
Ntombizodumo Nxasana
Keyword(s):  
South Africa ◽  
Bacterial Vaginosis ◽  
Health Centre ◽  
Signs And Symptoms ◽  
Antibiotic Use ◽  
Hiv Positive ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Hiv Negative

Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent’s score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4–8.5; p = 0.005 ). Women aged above 35 years were highly likely to develop BV ( p = 0.049 ). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients ( p = 0.030 ). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients ( p = 0.044 ). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.

scholarly journals The experience, results, and possible perspectives of organizing the optimally accessible primary medical care for the rural population of Zaporizhzhia region

2021 ◽  
Vol 14 (3) ◽  
pp. 369-373
Author(s):  
O. H. Aleksieiev ◽  
V. V. Taranov ◽  
V. P. Petrykhin
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Rural Population ◽  
Healthcare Facility ◽  
Service Area ◽  
Healthcare Facilities ◽  
Care Facilities

Nowadays, the assessment of the activity of the domestic healthcare system is an important and actual issue, especially against the background the active reformation of this industry. One of the important elements of the assessment is studying the availability of primary healthcare to the rural population. The aim of this work is to study the territorial accessibility of primary healthcare, the adequacy and effectiveness of the principles of forming a network of primary care facilities in the rural areas of Zaporizhzhia region that enables to address issues and optimize the location of primary care facilities in the rural areas. Materials and methods. The materials of the research were the data of the official statistical reports for the past 20 years, which characterize the state of health and the degree of medical care accessibility to the rural population. During the research, the technique of complex social and hygienic research was applied, with the use of historical, sociological, sanitary and statistical methods, organizational experiment and others. Results. The article presents the main results of studying the current state of primary healthcare organization for the rural population of Zaporіzhzhia region against the background of active reforming processes. According to the research results, the main elements forming the system of accessibility are territorial, medical, social and economic. The main factors of impact on territorial accessibility are identified. These are: the nature of the settlement of rural residents (density, compactness, service-area radius, the proportion of the rural population, the distance between villages, the distance from a household to a healthcare facility); quality of roads; transport connections between settlements and healthcare facilities; availability of communication means. Conclusions. As a result of the research, the following conclusions were drawn. Such factors as population density, compactness of its location, service-area radius, distance between villages, distance from a household to a healthcare facility, condition and quality of roads, transport connections between settlements and healthcare facilities are important during forming or improving the network of healthcare facilities in rural areas. These factors must be considered for the rational placement of primary care facilities in rural areas.  

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