scholarly journals Adolescents’ experience of a rapid HIV self-testing device in youth-friendly clinic settings in Cape Town South Africa: a cross-sectional community based usability study

2016 ◽  
Vol 19 (1) ◽  
pp. 21111 ◽  
Author(s):  
Philip Smith ◽  
Melissa Wallace ◽  
Linda-Gail Bekker
BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033643
Author(s):  
Peter W Hodkinson ◽  
Jennifer Lee Pigoga ◽  
Lee Wallis

ObjectiveEmergency care is a key component of healthcare systems, but little is known about its real impact on communities. This study evaluated access, utilisation and barriers to healthcare, and specifically emergency care, in the low socioeconomic Cape Town suburb of Lavender Hill.DesignA cross-sectional, community-based household survey.SettingLavender Hill suburb in the Cape Flats of Cape Town, South Africa.ParticipantsTwo-stage cluster sampling was used to identify approximately 13 households in each of 46 clusters, for a total of 608 households. A senior householder responded on behalf of each household surveyed.Primary outcome measuresAccess to, utilisation of and unmet needs related to healthcare at large and emergency care.ResultsIn August 2018, 608 households were surveyed, encompassing 2754 individuals, with a response rate of 96.4%. Almost a quarter of respondents (n=663, 24.1%) used the healthcare system within the last year. Female gender, advancing age, lower levels of education, recipients of disability grants, smaller household sizes and living in formal dwellings were factors associated with increased risk of unmet healthcare and emergency care needs. Only a small proportion of respondents (n=39, 1.4%) reported having unmet emergency healthcare needs, with wait times at facilities (n=9, 23.1%), emergency medical service delays (n=7, 17.9%) and personal safety (n=6, 15.4%) being prominent. There was a high prevalence of chronic medical conditions (hypertension, diabetes and dyslipidaemias) and recent deaths predominantly from trauma and malignancy.ConclusionThe emergency healthcare needs of the community appear to be well catered for, although community expectations may not be high and many barriers exist, particularly in accessing emergency care—be it via ambulance services or at healthcare facilities—and caring for chronic diseases in the ageing population. The Lavender Hill community could benefit from programmes addressing chronic disease management and emergency care delivery within the community.


Author(s):  
Jason September ◽  
Leon Geffen ◽  
Kathryn Manning ◽  
Preneshni Naicker ◽  
Cheryl Faro ◽  
...  

Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.


PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0195208 ◽  
Author(s):  
Sue-Ann Meehan ◽  
Rosa Sloot ◽  
Heather R. Draper ◽  
Pren Naidoo ◽  
Ronelle Burger ◽  
...  

PLoS Medicine ◽  
2012 ◽  
Vol 9 (8) ◽  
pp. e1001281 ◽  
Author(s):  
Katharina Kranzer ◽  
Stephen D. Lawn ◽  
Gesine Meyer-Rath ◽  
Anna Vassall ◽  
Eudoxia Raditlhalo ◽  
...  

2013 ◽  
Vol 16 ◽  
pp. 18754 ◽  
Author(s):  
Elizabeth Batist ◽  
Benjamin Brown ◽  
Andrew Scheibe ◽  
Stefan D Baral ◽  
Linda-Gail Bekker

Author(s):  
D Schuster ◽  
JJ Fagan ◽  
M Flint ◽  
W Basera ◽  
O Porrill ◽  
...  

Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics, and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spreadsheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5–58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.


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