scholarly journals Factors influencing treatment outcomes in tuberculosis patients in Limpopo Province, South Africa, from 2006 to 2010: A retrospective study

Curationis ◽  
2014 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammed M. Gafar ◽  
Norman Z. Nyazema ◽  
Yoswa M. Dambisya
Keyword(s):  
South Africa ◽  
Treatment Outcomes ◽  
Health Facility ◽  
Treatment Regimen ◽  
Diagnostic Category ◽  
Limpopo Province ◽  
World Health ◽  
Factors Influencing ◽  
Health Facility Level ◽  
Facility Level

Background: South Africa has a high burden of tuberculosis (TB), with high human immunodeficiency virus (HIV)-TB co-infection rates and the emergence of multidrugresistant TB.Objectives: To describe treatment outcomes and factors influencing outcomes amongst pulmonary TB (PTB) patients in the Limpopo Province.Method: A retrospective review was conducted of data on the provincial electronic TB register (ETR.net) for the years 2006 to 2010 (inclusive), and a random sample of 1200 records was selected for further analysis. The Chi square test was used to examine the influence of age, gender, health facility level, diagnostic category and treatment regimen on treatment outcomes.Results: Overall 90 617 (54.6% male) PTB patients were registered between 2006 and 2010. Of the sampled 1200 TB cases, 72.6% were in persons aged 22 to 55 years and 86.2% were new cases. The TB mortality rate was 13.6% (much higher than the World Health Organization target of 3%), whilst the default rate was 9.8%. There was a strong association between age (P < 0.001), diagnostic category (P < 0.001), treatment regimen (P < 0.001), and health facility level (P < 0.001) and treatment outcome. Those aged 22–55, and 56–74 years were more likely to die (P < 0.05). Poor treatment outcomes were also associated with initial treatment failure, receiving treatment at hospital and treatment regimen II.Conclusion: The poor TB treatment outcomes in Limpopo, characterised by a high mortality and default rates, call for strengthening of the TB control programme, which should include integration of HIV and/or AIDS and TB services. 

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Characterisation of smectite-rich clay soil: Implication for groundwater defluoridation

2016 ◽  
Vol Volume 112 (Number 11/12) ◽  
Author(s):  
Rabelani Mudzielwana ◽  
Mugera W. Gitari ◽  
Titus A.M. Msagati ◽  
◽  
◽  
...  
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Contact Time ◽  
Clay Soil ◽  
Dental Fluorosis ◽  
Fluoride Concentration ◽  
Limpopo Province ◽  
World Health ◽  
Fluoride Removal ◽  
X Ray

Abstract Groundwater is a widely used and affordable source of drinking water in most of the rural areas of South Africa. Several studies have indicated that groundwater in some boreholes in South Africa has a fluoride concentration above the level recommended by the World Health Organization (1.5 mg/L). Fluoride concentrations above the permissible limit (>1.5 mg/L) lead to dental fluorosis, with even higher concentrations leading to skeletal fluorosis. In the present work, we evaluate the application of smectite-rich clay soil from Mukondeni (Limpopo Province, South Africa) in defluoridation of groundwater. The clay soil was characterised by mineralogy using X-ray diffraction, by elemental composition using X-ray fluorescence and by morphology using scanning electron microscopy. Surface area and pore volume was determined by the Brunauer–Emmett–Teller surface analysis method. Cation exchange capacity and pHpzc of the soil were also evaluated using standard laboratory methods. Batch experiments were conducted to evaluate and optimise various operational parameters such as contact time, adsorbent dose, pH and initial adsorbate concentration. It was observed that 0.8 g/100 mL of smectite-rich clay soil removed up to 92% of fluoride from the initial concentration of 3 mg/L at a pH of 2 with a contact time of 30 min. The experimental data fitted well to a Langmuir adsorption isotherm and followed pseudo second order reaction kinetics. Smectite-rich clay soil showed 52% fluoride removal from field groundwater with an initial fluoride concentration of 5.4 mg/L at an initial pH of 2 and 44% removal at a natural pH of 7.8. Therefore smectite-rich clay soil from Mukondeni has potential for application in defluoridation of groundwater. Chemical modification is recommended to improve the defluoridation capacity.

A systematic review of vaccine availability at the national, district, and health facility level in the WHO African Region

2020 ◽  
Vol 19 (7) ◽  
pp. 639-651
Author(s):  
Chinwe Juliana Iwu ◽  
Ntombehle Ngcobo ◽  
Anelisa Jaca ◽  
Alison Wiyeh ◽  
Elizabeth Pienaar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Facility ◽  
African Region ◽  
Health Facility Level ◽  
Facility Level ◽  
Vaccine Availability

scholarly journals Baseline results of the first malaria indicator survey in Iran at the health facility level

2011 ◽  
Vol 10 (1) ◽  
pp. 319 ◽  
Author(s):  
Ahmad Raiesi ◽  
Fatemeh Nikpour ◽  
Alireza Ansari-Moghaddam ◽  
Mansoor Ranjbar ◽  
Fatemeh Rakhshani ◽  
...  
Keyword(s):  
Health Facility ◽  
Malaria Indicator Survey ◽  
Health Facility Level ◽  
Facility Level

scholarly journals Spectroscopic Determination of Water Salinity in Brackish Surface Water in Nandoni Dam, at Vhembe District, Limpopo Province, South Africa

Water ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 990 ◽  
Author(s):  
Lebea Nthunya ◽  
Sebabatso Maifadi ◽  
Bhekie Mamba ◽  
Arne Verliefde ◽  
Sabelo Mhlanga
Keyword(s):  
South Africa ◽  
Water Supply ◽  
Water Samples ◽  
Water Resource Management ◽  
Treatment Plant ◽  
Limpopo Province ◽  
World Health ◽  
Water Salinity ◽  
Vhembe District ◽  
Dissolved Salts

The problem of limited water supply in the Vhembe District (Limpopo Province, South Africa) is exacerbated by a preponderance of dissolved salts, which cause disagreeable taste and odour in the water as reported by the communities using this water for drinking. The water treatment plant that supplies the treated water to the communities in the District sources this raw water from the Nandoni Dam at the Luvuvhu river catchment. There are no scientific studies that have been reported in the literature that focused on determining the levels of water salinity from various water sources in the municipalities of the District. Water samples from various sites across the Nandoni Dam, a primary source of domestic water supply in the region, were collected through each season over a period of twelve months in order to ascertain the concentrations of dissolved salts in the dam. Onsite analyses of the water samples were conducted using the YSI ProDSS multimeter, while the laboratory water analyses were conducted using the spectroquant and atomic absorption spectrometers. Although salinity tests seem to indicate that the water sampled across most of the Nandoni Dam is brackish during all seasons of the year with the highest being 750 mg/L, water samples from the dam mid-outlet and the treatment plant are slightly below the World Health Organization (WHO) brackish water bracket of 500 mg/L with unfavourable taste for drinking. Results from this study indicate that the water sourced from the Nandoni Dam is not suitable for human consumption and therefore requires integrated water resource management, as well as robust and cost-effective water desalination treatment.

scholarly journals The influence of health facility-level access measures on modern contraceptive use in Kinshasa, DRC

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236018
Author(s):  
Saleh Babazadeh ◽  
Philip Anglewicz ◽  
Janna M. Wisniewski ◽  
Patrick K. Kayembe ◽  
Julie Hernandez ◽  
...  
Keyword(s):  
Health Facility ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Health Facility Level ◽  
Modern Contraceptive Use ◽  
Facility Level

scholarly journals Measuring governance at health facility level: developing and validation of simple governance tool in Zambia

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Wilbroad Mutale ◽  
Margaret Tembo Mwanamwenge ◽  
Dina Balabanova ◽  
Neil Spicer ◽  
Helen Ayles
Keyword(s):  
Health Facility ◽  
Health Facility Level ◽  
Facility Level

Evaluation of the Zimbabwe HIV Case Surveillance Pilot Program, 2019 (Preprint)

2020 ◽  
Author(s):  
Peter Nsubuga ◽  
Simbarashe Mabaya ◽  
Tsitsi Apollo ◽  
Ngwarai Sithole ◽  
Brian Komtenza ◽  
...  
Keyword(s):  
Child Care ◽  
Viral Load ◽  
Health Facility ◽  
Lessons Learned ◽  
Load Test ◽  
Test Results ◽  
Health Facility Level ◽  
Viral Load Test ◽  
Facility Level ◽  
Roll Out

BACKGROUND Zimbabwe has a high burden of HIV, with an estimated 1.3 million people living with the virus and an HIV prevalence and incidence of 13.8% and 0.48%, respectively (2017 Spectrum estimates). In 2017, the Zimbabwe Ministry of Health and Child Care (MOHCC) developed and implemented a pilot of HIV case surveillance (CS) based on the 2017 World Health Organisation (WHO) Person-centred HIV patient monitoring (PM) and case surveillance guidelines. As the case surveillance guidelines were new, lessons learned from field implementation experiences were intended to inform the development of HIV case surveillance implementation guidance and tools. OBJECTIVE At the end of the pilot phase, the Ministry of Health and Child Care (MOHCC) commissioned an evaluation to inform further steps. METHODS Two districts, Umzingwane in Matabeleland South Province and Mutare in Manicaland Province were commissioned to run the CS pilot from August 2017 to December 2018. During this period, 1602 people living with HIV (PLHIV) newly diagnosed with HIV were reported in the CS system, while other HIV sentinel events, including ART initiation and first viral load test, were routinely reported. A mixed-methods cross-sectional study of stakeholders and health facility staff was used to assess the following CS system features: design and operations, performance, usefulness, sustainability and scalability. A total of 13 stakeholders responded to an online questionnaire, while 33 health facility respondents were interviewed in 11 health facilities in the two pilot districts. RESULTS The HIV CS system was adequately designed for Zimbabwe’s context, integrated within existing health information systems at the facility level. However, the training was minimal, and an opportunity to train the data entry clerks in data analysis was missed. The system performed well in terms of surveillance and informatics attributes. However, viral load test results return was a significant problem. The system was used at the health facility level to track the HIV positive clients in their catchment area; all facilities that were visited were aware of what is happening to their clients. Almost all respondents believed that the country can roll out the HIV CS system to all facilities with partner support. CONCLUSIONS The HIV CS system was found useful at the health facility level and should be rolled out in a phased manner, beginning with all facilities in Manicaland and Matabeleland South provinces. An electronic link needs to be made between the health facilities and the laboratory to reduce viral load test results delays. Lessons learned from the provincial roll out can be used for a nationwide scale-up.

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