Faculty of Health Sciences
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Item Practice-related hygiene behaviours utilized by Chiropractors pre, during and post the COVID-19 pandemic in South Africa.(2024) Enslin, Jan-Frederik; Krishna, Suresh Babu Naidu; O’Connor, LauraBackground: The COVID-19 pandemic had an impact on the delivery of healthcare services worldwide. The Allied Health Professions Council of South Africa implemented regulations to control the spread of the virus, including social distancing, face masks/shields, hand sanitisation, surface disinfection, and protective shields. Chiropractors had to incorporate new hygiene measures to ensure the safety of their patients and themselves. Without adherence to proper hygiene protocols, manual therapy poses a substantial risk of transmission for both the practitioner and the patient. There is limited information available regarding the changes made by chiropractors to their practices in response to the pandemic and if these changed behaviours are still being implemented. Exploring and understanding changes in behaviour can help identify areas where chiropractors may need additional support or resources to adapt to new circumstances and can provide valuable information on how the pandemic has impacted the field of chiropractic care. Additionally, by studying how chiropractors adapted during the pandemic can help gain insight into best practices for future challenges or crises that may arise, as well as can help improve patient care and outcomes in the future. Aim: To determine the practice-related hygiene behaviours of chiropractors before, during and post the COVID-19 pandemic in South Africa. Methodology: An anonymous online survey was completed by registered Chiropractors in South Africa (n=119) registered with the Allied Health Professions Council of South Africa, having provided informed consent. The survey consisted of questions related to practice hygiene behaviours pre, during and post the COVID-19 pandemic and distributed via a link on QuestionPro®. The survey closed on 02/02/2024. Results: The study examined the distribution of hand and equipment disinfection in a healthcare setting, before and after the COVID-19 pandemic. The response rate for the survey was 22.45%. A total of 36% of chiropractors had been practicing for seven years and 60% lived in urban or major cities. Most practitioners returned to their work in level 4 of lockdown and practiced as a sole practitioner. The study found a significant statistical difference that sanitiser availability and the use of personal protective equipment were less prevalent before and after the pandemic than during the pandemic. Most chiropractors (78%) felt that the COVID-19 hygiene protocols made them more aware about practice hygiene behaviours. However, 30% of chiropractors believed they were likely to contract COVID-19 if they did not adhere to proper hygiene practices. Barriers to implementing hygiene practices during COVID-19 included patient reluctance, lack of time, resources and difficulty in adhering to hygiene practices. Half of the chiropractors agreed to continue with good hygiene practices post COVID-19. Conclusion: The COVID-19 pandemic resulted in increased adherence to practice related hygiene behaviours with the implementation of safety precautions such as protective screens and face masks. Many of the chiropractors continued to utilise these behaviours after the pandemic.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 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 Allopathic medicine practitioners' perspectives on facilitating disclosure of traditional medicine use in Gauteng, South Africa : a qualitative study(Springer Science and Business Media LLC, 2023-12-12) Gumede, Lindiwe; Nkosi, Pauline B.; Sibiya, Maureen N.Traditional medicine (TM) plays a key role in maintaining health in many societies. Given the requirement for TM disclosure, Allopathic Medicine Practitioners (AMPs) must encourage open communication with patients to persuade those who use TM to disclose. Addressing patient non-disclosure of TM requires this dialogue to be facilitated. We sought to understand and describe how South African AMPs facilitate disclosure of TM use during a consultation with patients who use both TM and allopathic medicine (AM) and how it influences the patients' willingness to disclose TM use.Methods
This qualitative exploratory descriptive study on AMPs at Gauteng district public hospitals in South Africa was conducted between 2021 and 2022. Non-probability purposive sampling was employed to select a sample of 14 AMPs. Individual participants were encouraged to share their unique experiences and interpretations of the phenomenon concerning TM use disclosure. The raw transcribed textual data were processed using ATLAS.ti, and inductive content analysis was undertaken following the coding of the content to identify categories.Results
The data revealed four major categories: 'providing a suitable atmosphere for disclosure,' 'encouraging patients to disclose TM usage to AMPs,' 'patient autonomy,' and 'AMP training'. During a consultation with patients who use both TM and AM, participants expressed their experiences and perceptions of TM nondisclosure. They also discussed several methods for encouraging patients to disclose their TM usage, particularly when TM is used concurrently with AM.Conclusion
This study expands on previously reported findings by describing how South African AMPs facilitate the disclosure of TM use during consultation. Many AMPs struggle to initiate TM conversations with their patients which results in non-disclosure. This study revealed that integrating TM into AM training programmes, promoting cross-practice, and creating a safe environment is necessary for the development and application of the most appropriate approaches that would assist in facilitating disclosure.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 Guidelines for disclosure of traditional medicine use to allopathic medicine practitioners by patients who use both traditional and allopathic medicines at selected hospitals in Gauteng, South Africa(2022-11) Gumede, Lindiwe; Nkosi, Pauline Busisiwe; Sibiya, Maureen NokuthulaBackground Within the South African context, the concurrent use of traditional medicine (TM) and allopathic medicine (AM) is often not disclosed to allopathic medicine practitioners (AMPs) during a consultation. It is quite common for patients to consult with traditional health practitioners (THPs) prior to reaching out to AMPs for further assistance. When compared to AM, TM used by patients who use both TM and AM has on many occasions been perceived as a sub-standard treatment option. Non-disclosure of TM use by patients who use both TM and AM may render the AM prescribed by the AMPs ineffective if not detected in a timely manner. While there is literature that identifies the reasons why patients who use both TM and AM do not disclose this to AMPs during a consultation, no guidelines have been developed to focus on facilitating disclosure by these patients. Aim The aim of the research was to explore and describe the perceptions of AMPs regarding disclosure of TM use to AMPs by patients who use both TM and AM and ultimately to develop guidelines for disclosure of TM use to AMPs at selected hospitals in Gauteng. Methodology An exploratory, descriptive, qualitative research design was employed. The opinions of AMPs who met the non-probability, purposive sampling inclusion criteria were explored and described. Data was gathered through one-on-one, masked semi-structured interviews and qualitative observations of AMPs in their natural environment. The findings were triangulated and integrated with Petronio's communication privacy management (CPM) theory as a theoretical framework informing the study to help delineate correspondence concerning the phenomenon. Findings The findings of the one-on-one, semi-structured interviews reveal that the practice of AMPs in Gauteng regarding the concurrent use of TM and AM by patients they consult with is limited by their knowledge of the TM used by these patients. Secondary elements of non-disclosure include stigma, AMP attitudes, AMP training, belief systems, lack of knowledge, lack of communication skills, scoffing at TM and prejudice. The research findings prompted the development of guidelines and recommendations for stakeholders involved in patient care and management in Gauteng.Item A qualitative exploration into the presence of TB stigmatization across three districts in South Africa(Springer Science and Business Media LLC, 2023-03-15) DeSanto, Daniel; Velen, Kavindhran; Lessells, Richard; Makgopa, Sewele; Gumede, Dumile; Fielding, Katherine; Grant, Alison D.; Charalambous, Salome; Chetty-Makkan, Candice M.Tuberculosis (TB) stigma is a barrier to active case finding and delivery of care in fighting the TB epidemic. As part of a project exploring different models for delivery of TB contact tracing, we conducted a qualitative analysis to explore the presence of TB stigma within communities across South Africa.Methods
We conducted 43 in-depth interviews with 31 people with TB and 12 household contacts as well as five focus group discussions with 40 ward-based team members and 11 community stakeholders across three South African districts.Results
TB stigma is driven and facilitated by fear of disease coupled with an understanding of TB/HIV duality and manifests as anticipated and internalized stigma. Individuals are marked with TB stigma verbally through gossip and visually through symptomatic identification or when accessing care in either TB-specific areas in health clinics or though ward-based outreach teams. Individuals' unique understanding of stigma influences how they seek care.Conclusion
TB stigma contributes to suboptimal case finding and care at the community level in South Africa. Interventions to combat stigma, such as community and individual education campaigns on TB treatment and transmission as well as the training of health care workers on stigma and stigmatization are needed to prevent discrimination and protect patient confidentiality.Item Learning style preferences of chiropractic students at a university of technology and their effect on academic performance(2022-05-13) Dinkelmann, Kate Lynn; Ally, Fazila; Prince, FazilaBackground South Africa’s higher education institutions have been described as systems of low participation and high attrition (Cloete 2014:1358). Despite the government’s investments into its education sector, graduation rates, especially those at the undergraduate level, remain very low. A diversified student body makes up the tertiary education institutions. These students vary in age, gender, race and socioeconomic backgrounds, which have fuelled the need to investigate strategies to improve the learning experience so students may achieve their full potential. There is a paucity of research specific to learning style preferences and chiropractic education with many of those studies done not being applicable to a university of technology in South Africa. Aim The aim of the study was to determine the learning style preferences of registered chiropractic students at the Durban University of Technology, In KwaZulu-Natal, South Africa, and to determine the relationship of these preferences to their demographics and academic performance. Research methodology Using a quantitative research approach, 142 chiropractic students registered in years one to five of the chiropractic programme in 2019 were asked to complete a cross-sectional survey comprised of basic demographical information and a Visual, Aural, Read/write and Kinaesthetic (VARK) questionnaire. The research tool was administered through QuestionPro, and later hard copies of the questionnaire were offered if the respondents were unable to initially complete the online questionnaire. Results and discussion There were 101 chiropractic students who participated in this study resulting in a 76.5% response rate. The majority of the students were found to be unimodal learners (61.4%) and the most selected unimodal preference was the kinaesthetic mode (36.6%). No significant difference in the distribution of learning style preferences were found by year of study, gender or age (p=0.893, p=0.228 and p=0.153, respectively), although a slight trend was observed, where read/write learning was the more popular preference amongst the youngest and visual learning was preferred amongst the oldest students. This research study also found there to be no significant relationship between learning style preferences and academic performance in theory and practical examinations (p=0.161 and p=0.083, respectively). Conclusion and recommendations Although many of the chiropractic students were found to have unimodal preferences, this study highlighted the diversity of learning style preferences amongst the students. No specific learning styles were found to predict a better examination outcome but allowing students to explore their learning preferences and utilize techniques that are best suited to them may enhance their education. Future studies should examine the learning style preferences of the chiropractic lecturers and clinicians, and compare these with the preferences of the students, who typically adapt their learning preferences to suit their learning environment (Almigbal 2015:349).Item Occupational blood and body fluid exposure among emergency medical service providers in the eThekwini metropole of South Africa(Elsevier BV, 2022-06) Chetty, Melvin; Govender, Kevin P.; Sobuwa, SimpiweEmergency Medical Service (EMS) providers in South Africa are among health care workers (HCW) most at risk of contracting infectious diseases due to occupational exposure to blood and body fluids (BBF). While the austere, dynamic, and challenging nature of the prehospital environment appears to be one of the primary drivers to this risk, the growing prevalence of bloodborne infections within the country; particularly Hepatitis B, C and Human Immunodeficiency Virus (HIV), has inevitably compounded the problem. The aim of this study was to investigate the knowledge, practices, and prevalence of BBF exposure among EMS providers in the eThekwini metropole of KwaZulu-Natal, South Africa.Methodology
This cross-sectional questionnaire-based study was completed by 96 randomly selected EMS providers who worked for the state-run ambulance service and were stationed within the eThekwini metropole.Results
A total of 41 (42.7%) of the 96 respondents indicated memorable exposure to BBF at some point in their operational career. Exposure appeared to be mostly as a result of needlestick injuries (NSI) (63.4%), followed by BBF exposure into the eyes (19.5%). At the time of exposure, a total of 40 participants (97.6%) were wearing gloves, 22% (n = 9) were wearing facemasks, and 9.8% (n = 4) were wearing eye protection. Less than half of the respondents (46, 47.9%) were aware of existing EMS espoused BBF exposure policies, and 55 (57.3%) knew about post-exposure prophylaxis for HIV. Majority of the respondents (n = 74; 77.1%) indicated that they always recapped needles, and 46.9% (n = 45) dispose of sharps containers when completely full.Conclusion
The findings suggest that BBF related knowledge and practices among EMS providers working in the eThekwini metropole may be inadequate, and may increase the risk of blood exposure. In order to improve knowledge, immediate provision of EMS-specific BBF exposure training is required.