Research Publications (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216
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Item Provision of HIV testing services and its impact on the HIV positivity rate in the public health sector in KwaZulu-Natal : a ten-year review(Informa UK Limited, 2024-12) Desai, Rizwana; Onwubu, Stanley; Lutge, Elizabeth; Buthelezi, Nondumiso Patience; Moodley, Nirvasha; Haffejee, Firoza; Segobe, Bontle; Krishna, Suresh Babu Naidu; Sibiya, Maureen Nokuthula; Jinabhai, Champaklal ChhaganlalSouth Africa has been rated as having the most severe HIV epidemic in the world since it has one of the largest populations of people living with HIV (PLHIV). KwaZulu-Natal (KZN) is the epicentre of the HIV epidemic. The HIV test and treat services in the public health sector are critical to managing the epidemic and responding to the increase in HIV infections. The KwaZulu-Natal Department of Health (DOH) commissioned a review of the provision of HIV testing services in the province and aimed to investigate its impact on the HIV positivity rate over a ten-year period. The study was an ecological study design using data extracted from the Department's District Health Information System (DHIS). Descriptive analysis was conducted in addition to ANOVA and multiple regression analysis. The results of this study have shown that the total number of HIV tests conducted over the ten-year period in the province has increased with the highest number of HIV tests being conducted in the 2018/2019 MTEF year. ANOVA analysis indicates that there was a statistically significant difference in the total number of HIV tests conducted and the number of HIV tests per 100 000 population across the province's 11 districts (p < 0.001). Statistically significant differences were observed in the HIV testing rate and in the HIV positivity rate over the period (p < 0.001). Results from multiple regression analysis showed that the HIV testing rate per 100 000 population was the strongest predictor of the HIV positivity rate. HIV positivity among clients correlated negatively with the number of HIV tests conducted per 100 000 population (r = -0.823; p < 0.001) and the HIV testing rate (r = -0.324; p < 0.01). This study has found that HIV testing could have an impact on reducing the positivity rate of HIV in the province and is therefore an effective strategy in curbing the HIV epidemic. The KwaZulu-Natal Department of Health should ensure that strategies for implementing and maintaining HIV testing and treating services should continue at an accelerated rate in order to achieve the first 95 of the UNAIDS 2025 SDG target.Item Allopathic medicine practitioners' experiences with non-disclosure of traditional medicine use(AOSIS, 2024-01-31) Gumede, Lindiwe; Nkosi, Pauline B.; Sibiya, Maureen NokuthulaA pertinent issue impacting patient treatment outcomes is the nondisclosure of traditional medicine (TM) use to Allopathic medicine practitioners (AMPs). For years, TM has been a controversial practice, with patients often using it alongside allopathic medicine without disclosing their use. It is imperitive to learn and understand the experiences of AMPs regarding the disclosure of TM use in Gauteng province to enable them to provide the best possible treatment outcomes for patients who use TM.Aim
This study aimed to explore the experiences of AMPs regarding non-disclosure of TM use in Gauteng province.Setting
This study was conducted in four district hospitals where outpatient care and services are rendered in Gauteng Province.Methods
An interpretive phenomenological analysis (IPA) design was followed. Fourteen purposefully sampled AMPs participated in face-to-face, one-on-one, and semi-structured interviews. Interpretive phenomenological analysis in Atlas.ti was conducted.Results
Three themes emerged: bedside manner of AMPs; stigmatising TM use; and individual belief systems. The belief of patients' disclosure hesitancy because of fear of judgment by the AMPs underpinned these themes.Conclusion
Allopathic medicine practitioners are aware that patients who use TM could feel guilty and stigmatised. They acknowledged that patients use TM because of cultural and ethnic reasons, which should not be disregarded.Contribution
The study highlighted that patients do not disclose their TM use because of AMPs' attitudes, stigmatising TM use, and their prejudices against the cultural beliefs of patients. Allopathic medicine practitioners should establish good communication with patients by providing patient-centred communication to facilitate disclosure of TM use.Item Determinants and acceptability of HIV self-testing among vulnerable groups in sub-Saharan Africa : a scoping review protocol(BMJ, 2024-01-29) Anyiam, Felix Emeka; Sibiya, Maureen Nokuthula; Oladimeji, OlanrewajuHIV self-testing (HIVST) is where individuals collect their specimens and perform the HIV test privately. HIVST has improved testing uptake and coverage, especially among vulnerable groups of sub-Saharan Africa (SSA). Vulnerable groups include key populations such as men who have sex with men, sex workers, people who inject drugs, lesbian, gay, bisexual and transgender persons and young women. However, little is known about the determinants and acceptability of HIVST among these groups in SSA. Therefore, this scoping review aims to explore the determinants and acceptability of HIVST among vulnerable groups in SSA.Methods
A scoping review will be conducted using the Arksey and O'Malley framework and further refined by Levac framework. The review will follow a six-step approach: (1) identifying the research question, (2) identifying relevant studies, (3) study selection eligibility, (4) charting the data, (5) collating, summarising and reporting the results and (6) consultation. A comprehensive search strategy will be developed, and the following electronic databases will be searched: MEDLINE, Embase, Global Health and the Cochrane Library. Grey literature will also be searched, including conference abstracts and reports. Eligibility criteria will include studies conducted in SSA, published between 2010 and 2023, focusing on vulnerable groups and exploring the determinants and acceptability of HIVST. Two independent reviewers will screen identified studies' titles, abstracts and full texts. Any disagreements will be resolved through discussion or consultation with a third reviewer. Data extraction will be conducted using a standardised form.Ethics and dissemination
This review, not requiring ethical approval, aims to inform policy and intervention design to boost HIV testing adoption within vulnerable communities. We plan to disseminate our findings via a peer-reviewed journal, policy briefs, conference presentations and stakeholder engagement.Item Factors predisposing emergency medical technicians to workplace violence: a cross sectional study(SAGE Publications, 2024) Khoza, Tshikani Lewis; Sibiya, Maureen Nokuthula; Mshunqane, NombekoEmergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking. Thus, the aim of this study was to investigate the factors that predispose public service EMTs' to workplace violence in Gauteng Province. Data were collected using questionnaires. A total of 413 questionnaires were returned by community members of Gauteng who met the inclusion criteria. Descriptive statistics and binomial tests were used to analyze data. The results of this study revealed that workplace violence toward public service EMTs' in Gauteng is attributed to the high rates of crime, the widening gap of inequality, economic deprivation of basic rights to previously disadvantaged communities by government, vulnerability of EMTs' when responding to the ill and injured within low- and middle-income communities and a lack of consequence for disorderly behavior within the communities. An understanding of the community factors that predispose EMTs' to workplace violence may improve the understanding of the phenomenon of workplace violence and developing prevention programs within the communities.Item Exploring the lived experiences of vulnerable females from a low-resource setting during the COVID-19 pandemic(MDPI AG, 2023-11-09) Haffejee, Firoza; Maharajh, Rivesh; Sibiya, Maureen NokuthulaThe onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.Item Ethical and methodological reflections : digital storytelling of self-care with students during the COVID-19 pandemic at a South African University(Public Library of Science (PLoS), 2023-01) Gumede, Dumile; Sibiya, Maureen NokuthulaThe enforcement of the coronavirus disease 2019 (COVID-19) pandemic restrictions disrupted the traditional face-to-face qualitative data collection in public health. The pandemic forced qualitative researchers to transition to remote methods of data collection such as digital storytelling. Currently, there is a limited understanding of ethical and methodological challenges in digital storytelling. We, therefore, reflect on the challenges and solutions for implementing a digital storytelling project on self-care at a South African university during the COVID-19 pandemic. Guided by Salmon's Qualitative e-Research Framework, reflective journals were used in a digital storytelling project between March and June 2022. We documented the challenges of online recruitment, obtaining informed consent virtually, and collecting data using digital storytelling as well as the efforts of overcoming the challenges. Our reflections identified major challenges, namely online recruitment and informed consent compromised by asynchronous communication; participants' limited research knowledge; participants' privacy and confidentiality concerns; poor internet connectivity; quality of digital stories; devices with a shortage of storage space; participants' limited technological skills; and time commitment required to create digital stories. Strategies adopted to address these challenges included an ongoing informed consent process; flexible timelines for the creation of digital stories; one-on-one guidance on creating digital stories; and multiple online platforms to share digital stories. Our critical reflection offers practical guidance for the ethical conduct of digital storytelling in public health research and makes a significant contribution to methodological considerations for use in future pandemics. These ethical and methodological challenges should be recognized as features of the context of the research setting including restrictions imposed by the COVID-19 pandemic than disadvantages of digital storytelling.