Faculty of Health Sciences

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Development of an HIV risk index for university students in KwaZulu-Natal, South Africa
(2024) Pillay, Trishka; Reddy, Poovendhree; Govender, Nalini
Background: Human Immunodeficiency Virus (HIV) infection is a global health challenge, with developing countries most affected by the HIV burden. In South Africa (SA), young people aged 15 to 24 years are exceptionally vulnerable to HIV infection. University students are a segment of this vulnerable age group in SA. Significant effort and resources have been invested in HIV prevention and treatment such as availability of free government issue condoms, a large-scale antiretroviral (ARV) programme and intensification of other public health interventions such as male medical circumcision (MMC) and the availability of Pre exposure prophylaxis (PrEP). Nonetheless, HIV still poses a critical public health challenge 40 years post discovery, particularly among young people. Factors that may increase susceptibility include substance usage, tendency to engage in risky sexual behaviours (RSBs) such as transactional sex, inconsistent condom usage and engaging in sex with multiple partners. Poverty may further perpetuate RSBs such as transactional sex for money or to acquire basic needs. University students form part of the country’s economic backbone and are the future leaders of the country, thus context driven HIV prevention interventions for this unique population are imperative. HIV risk is multidimensional and in order to develop effective prevention interventions, risk factors associated with RSBs and HIV seropositivity must be further explored. Aim: The study aimed to analyse the behavioural and socio-economic components of risk associated with HIV and health among student populations in an attempt to design an evidence based risk index. Methodology: This study used a case control study design. Study sites included the four major public sector higher educational institutions (HEIs) in KwaZulu-Natal, South Africa. A structured questionnaire was used to collect data using convenience sampling from the study population with consisted of 375 HIV uninfected students (controls) and 125 HIV infected students (cases). STATA-version 17 was used to conduct data analysis. Data collected from controls was initially used to conduct a preliminary analysis to explore the association between food insecurity which was a socio-economic risk factor and RSBs. Subsequently, the main analysis was undertaken to investigate associations of the following: socio-economic, behavioural and knowledge risk factors with RSBs and HIV seropositivity using bivariate analysis and logistic regression modelling. Results from the case control data analysed was used to develop an HIV risk index tool, for specific use among university students. Key findings: Preliminary data analysis of control data found significant associations between food insecurity and students engaging in transactional sex for money as well as to meet basic needs. Participants who were food insecure were twice as likely to have multiple sexual partners. The case control analysis with socio-economic risk factors revealed a significant association between socio-economic measures, RSBs and HIV seropositivity. Overall, food insecurity increased the likelihood of multiple partners, transactional sex for money, and transactional sex for basic needs. Students who accessed the government funding scheme and shared the bursary/ loan were more likely to be HIV seropositive. Results from the analysis on behavioural risk factors indicated that heavy episodic drinking [aOR: 2.73 (1.38; 5.44), 0.004], drugs before sex [aOR: 7.46 (2.11; 27.88), 0.003], and a higher number of lifetime sex partners (2 to 5 partners) [aOR: 4.22(1.69; 10.54), 0.002] and ≥ 6 partners [aOR: 16.36 (6.18; 43.28), 0.000] increased students’ likelihood of having multiple concurrent sex partners. High risk behaviours such as sex with multiple partners and inconsistent condom use were more prevalent among HIV uninfected students. Data from our study showed that both HIV infected, and uninfected students displayed a better understanding regarding modes of HIV transmission compared to prevention methods. Students with poor knowledge regarding HIV prevention were 2.34 times more likely to be HIV positive and those demonstrating poor knowledge about HIV transmission were 4.79 times more likely to be HIV positive. Several misconceptions regarding HIV transmission methods were prevalent among both HIV infected and uninfected students. The above findings regarding socio-economic, behavioural and knowledge risk factors were used to develop an HIV risk index tool based on logistic regression models. The risk index score comprises 17 factors and used an aggregated score to formulate three risk categories namely, low, medium, and high-risk categories. Questions were formulated for the risk index tool based on variables used in the data analysis. Conclusion: Our findings demonstrate that university students are at an increased risk of engagement in RSBs which may consequently lead to HIV infection. Therefore, it is of critical importance for public health officials to consider the multidimensional aspects of HIV risk in the university student population when designing interventions targeted at this vulnerable group. Risk measurement is important to guide HIV prevention methods such as Pre-exposure prophylaxis (PrEP). The developed risk index tool has the potential to serve as a powerful public health tool for measurement of HIV risk among university students in developing countries. However, further testing and evaluation is required before implementation.
The epidemiology of low back pain in construction workers in the eThekwini Municipality of KwaZulu-Natal
(2024) Moodley, Verushan; Pillay, Julian David
Background Low back pain (LBP) is a significant musculoskeletal disorder and a major occupational health concern globally. In developing countries, occupational LBP remains a major public health crisis, with high levels of LBP reported, resulting in high levels of absenteeism, disability, and a loss of productivity. Construction workers are involved in one of the most physically demanding occupations, making them exceedingly susceptible to LBP. They are also exposed to a variety of demographic, lifestyle, and occupational risk factors that may further predispose them to LBP. In South Africa, research on LBP amongst construction workers is currently lacking. The aim of this study was, therefore, to determine the epidemiology of LBP in construction workers in the eThekwini Municipality of KwaZulu-Natal. Methodology This study adopted a cross-sectional survey design. Participants were recruited from the two largest construction companies in the eThekwini Municipality. A sample size of 256 construction workers was used and questionnaires were provided to the participants at their respective companies. The questionnaire was divided into four sections, namely demographic factors, lifestyle factors, occupational factors, and LBP history. IBM SPSS version 28 was used to analyse the data. Descriptive statistics, such as mean, standard deviation and range, were used to summarise continuous data. Frequency counts and percentages were used to summarise categorical data. Risk factors for LBP were assessed for those who reported LBP. Pearson’s chi-square tests or Fisher’s exact tests were deemed as appropriate and were used to assess categorical factors, while t-tests were used to assess mean differences for continuous variables. A p-value of <0.05 was used to indicate statistical significance. Results A total of 256 construction workers in the eThekwini Municipality were investigated in this study. The mean age of the male participants was 34.2 ± 9.2 years, while the female participants were 37.5 ± 8.1 years. The mean BMI of the men was calculated as 24.1 ± 3.9 kg/m2 and for the women it was 32.0 ± 10.1 kg/m2. The females had a mean weight of 78.7 ± 18.7kg and the men had a mean weight of 69.8 ± 9.9 kg. The males had a mean height of 1.7 ± 0.1kg and the females had a mean weight of 1.6 ± 0.1 kg. The point and period prevalences were 16.8% (n=43) and 26.2% (n=67) respectively. The study reported that 54.3% of the participants experienced LBP on both sides of the lumbar spine, 43.2% experienced it daily, and 48.1% had mild pain. Factors such as height (p=0.507), weight (p=0.657), and BMI (p=0.657) were not significantly associated with LBP. It was noted that age (n=81; p=0.124) was marginally non-significantly higher in those with LBP. No association between LBP and sex was noted (p=0.517) and LBP was equally likely in men and women (31% in men and 37.5% in women). A longer duration of smoking (p=0.015), a higher number of cigarettes smoked per day (p=0.047), the presence of work-related stress (p=<0.001), personal stress, or both, were significantly associated with LBP. The general workers (43.2%; n=16), followed by the erectors (33.3%; n=6), were most likely to have LBP. The most frequently used treatment was getting advice from a general practitioner, 56.7% (n=17), followed by self-medication, 30% (n=9). Conclusion LBP continues to be a major health burden on construction workers, impacting their daily activities and causing disability. The prevalence of LBP reported in the study was similar to some of the previous studies, whilst it varied from others. Notwithstanding this, LBP in construction workers is a concern requiring urgent attention. A joint intervention strategy between health professionals and the construction industry is required. This will reduce absenteeism, stress, decreased productivity, and activity limitations.
The prevalence, selected risk factors and burden of primary headaches in lecturers at a University of Technology (UoT) in KwaZulu-Natal during the COVID-19 pandemic
(2024) Chetty, Deidre; Orton, Penelope Margaret; O’Connor, Laura
Background: Headaches are a common disabling condition that affect many people worldwide. Headaches have been under-studied in developing countries and there is a paucity of literature documenting headaches in lecturers. The COVID-19 pandemic has forced lecturers to adapt to online teaching, which may have resulted in headaches. It is envisaged that this research will be beneficial to chiropractors, other healthcare providers and lecturers. Aim of Study: The aim of this study was to determine the prevalence, selected risk factors and burden of primary headaches in lecturers at a university of technology (UoT) in KwaZulu Natal during the COVID-19 pandemic. Methodology: A quantitative, descriptive cross-sectional design, where 685 lecturers employed at the Durban University of Technology, through self-selection, were selected to participate, using consecutive sampling. A minimum sample size of 247 was calculated, using a confidence level of 95% and confidence interval of 5%. Lecturers from all six faculties were invited to participate. The headache-attributed restriction, disability, social handicap and impaired participation (HARDSHIP) questionnaire was administered electronically via QUESTIONPRO®. Each participant was required to initial a consent form prior to answering the questionnaire. The diagnostic algorithm was utilised to diagnose headaches according to the diagnostic questions in the HARDSHIP questionnaire. All data were captured on an Excel spreadsheet and subsequently analysed using SPSS version 28. Results: There was a total of 255 completed questionnaires. The mean age of respondents was 45.66 years old. Of the total sample (n=255), 51.8% were headache sufferers. Most respondents suffered from probable tension-type headache (41.9%; n=54), followed by migraine-type headache (27.9%, n=36). Social risk factors revealed a significant relationship between alcohol and headaches, and sleep deprivation and headaches. Medial risk factors revealed a significant relationship between a head injury and headache and sinusitis and headache. Although there was a relationship between psychological risk factors and headache, it was not significant. Many work-related risk factors were significantly related to headache. There was a greater number of headache sufferers who tested positive for COVID-19. Many respondents experienced loneliness and their workload increased during the pandemic. Most of the respondents’ headaches interfered with work, and they usually took medication to treat their headache. Conclusion: Headaches are common in lecturing staff with, tension type headaches being most prevalent. There are many risk factors which are strongly associated with headaches and its impact caused an interference with work and negatively affected the suffers mental health. Family, social or leisure activities are also neglected when a headache occurred. This study adds to the current literature on headache prevalence in the lecturer population and increases awareness.
The injury profile of musculoskeletal injuries, and the impact thereof, in amateur pole sports athletes in eThekwini municipality
(2024) Worth, Kim; Pillay, Julian David
Background: Pole sport has gained popularity worldwide, especially in South Africa. Due to the nature of the sport, there is growing evidence of unique musculoskeletal injuries that accompany the sport. Despite this, there is little information regarding the specific musculoskeletal injuries that occur in pole sport athletes and, thus, the sport has been compared to gymnastics and circus arts which include certain similarities. Research in pole sports specifically is essential in order to assist healthcare professionals to manage the injuries specific to the sport appropriately. Aim: The aim of this study was to determine the prevalence, selected risk factors and types of injuries that amateur pole sport athletes experience, as well as the impact of the musculoskeletal injuries and the level of care used. Methodology: A quantitative, descriptive, cross-sectional method was utilised with the distribution of online questionnaires to five pole studios in the eThekwini municipality, KwaZulu-Natal, South Africa. The questionnaire consisted of the following sections: demographics; training history; risk factors; musculoskeletal injuries; consequence of injury on sport and performance, quality of life and the management approaches and impact thereof. The data was analysed using the IBM SPSS version 28. Results: A total of 59 female participants over the age of 18 years old were included in this study. A high prevalence of musculoskeletal injury was found, with a lifetime prevalence of 49.2% (n=29), and period prevalence over 12 months of 40.7% (n=24). The majority of injuries were found to affect the upper limb but injuries to the spine and lower limb were still common. The most commonly reported location of injuries was the shoulder (64.3%, n=18), followed by the hand and wrist (46.4%, n=13), and then the neck (35.7%, n=10) and thoracic back (35.6%, n=10). The most common type of injury was a strain type injury (48.1%, n=14), followed by contusions (11.1%, n=3). Significant risk factors included high skill level (p value of 0.005), increased strength (p value of 0.010), performing warm-ups for longer than 10 minutes (p value of 0.053) and performing static stretching cool-downs (p value of 0.005). The impact of pole sport injuries on the participants’ pole performance demonstrated that despite the athletes’ recovery from injury taking more than six weeks, the majority of the athletes either stopped pole sport and other activities for one week or less or did not stop the activities at all. The impact of pole sports injuries on the participants’ quality of life was significant, especially affecting their ability to perform daily activities, decreasing their ability to sleep and decreasing their mood as a result of injury. Various management approaches, including self-medication, home remedies and complementary healthcare were utilised by participants. Self-medication and home remedies were found to be utilised more commonly compared to seeking help from healthcare professionals. Conclusion: This study demonstrated that musculoskeletal injuries are largely present in pole sport athletes for which various management approaches were utilised. The injuries impacted multiple aspects of the participants’ lives. The uniqueness of this sport provides an interesting platform for new research, especially with regard to musculoskeletal injuries, as shown in this study.
The spectrum and the effects of cardiovascular risk factors on the cardiac structure and function at Madadeni Provincial Hospital (Internal Medicine Department)
(2023-05) Gambushe, Nokwanda A.; Prakaschandra, Dorcas Rosaley; Mahomed, F. A.
Cardiovascular disease (CVD) is now a leading cause of death worldwide. According to the United Nations (UN), people who are above 60 years of age have a greater chance of developing CVD, and are projected to double in South Africa by 2050. There is clear evidence that patients with cardiovascular risk factors present with cardiac structural and functional abnormalities. Left ventricular remodelling is a major complication in patients with cardiovascular risk factors, particularly hypertension. Very few studies evaluating the structural and functional changes in response to CVD, and none, to the knowledge of the researcher, have been conducted on black Africans in South Africa in urban and rural areas Aim: The aim of the study was to determine the spectrum and the effects of cardiovascular risk factors on cardiac structure and function in patients presenting to Madadeni Provincial Hospital (Internal Medicine Department). Materials and method: The researcher systematically sampled 200 participants in the northern KwaZulu-Natal (KZN) region, presenting to Madadeni Provincial Hospital (Internal Medicine Department) and administered a questionnaire that collected their information on socio-demographic and cardiovascular risk factors. Other measurements included blood pressure, blood glucose, biochemical analysis and transthoracic echocardiography. The statistical analysis included descriptive statistics (frequency tables, bar and pie charts) and chi-squared and T tests to present the study findings and comparison between variables. A multinomial logistic regression analysis was performed to determine independent predictors for left ventricular geometry. Results: The mean age was 50.10 ± 16.188 (range: 18 – 79), with 114 (57.0%) females and 86 (43.0%) males. Black patients had the highest prevalence of cardiovascular risk factors (56, 87.0%), followed by Indians (27, 13.5%), whites (12, 6.0%) and mixed ancestry (5.4.0%). There was a high prevalence of modifiable cardiovascular risk factors with hypertension (HPT) being the leading factor (31.5%), followed by diabetes mellitus (17.0%). The prevalence of hypertension together with diabetes mellitus was 24.5%. Dyslipedemia was the lowest with 2.0%. The prevalence of left ventricular systolic function was normal in 174 (87.0%) participants and abnormal in 26 (13.0%). The prevalence of left ventricular diastolic dysfunction was 70.5% in women and 29.4% in men. There was a high prevalence of normal left ventricular geometry with 103 (51.5%), followed by concentric hypertrophy 72 (36.0%), eccentric remodelling 13 (6.5%), concentric remodelling 11 (5.5%), and eccentric hypertrophy with 0.5%. Metabolic syndrome was documented in 58.3% blacks, followed by 33.3% Indians and 8.3% whites. A multinomial logistic regression model was fitted with the dependent variable, which was left ventricle geometry. The independent variables were age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), HPT, diabetes mellitus and diastolic function. When comparing risk factors for concentric hypertrophy to the category ‘normal’, the significant variable was diastolic function (p value = 0.015). The risk factors for concentric remodelling was found to be SBP (p = 0.057) and BMI category morbid obese (p = 0.015). The risk factors for eccentric remodelling were found to be BMI category morbid obese (p = 0.002) and HPT (p = 0.016). Conclusion: The study has shown that there is a high prevalence of modifiable cardiovascular risk factors in the northern KZN region and many patients present with metabolic syndrome during the course of the disease. The study also revealed a high prevalence of left ventricular diastolic dysfunction and left ventricular geometric patterns in the studied population. The risk factors for left ventricular geometry were HPT, morbid obesity, diastolic function and SBP.
Prevalence and risk factors of occupational injuries among emergency care providers
(2020-11-30) Chule, Ntuthuko Gift; Govender, Kevin; Sobuwa, Simpiwe
Introduction: Occupational injuries and diseases affect approximately 260 million people worldwide and kill nearly 2.3 million people per year. While paramedics and other healthcare workers (HCWs) are responsible for ensuring the health of others, their working environment is also considered to be one of the most hazardous environments. Purpose: To describe the prevalence and risk factors associated with occupational injuries, as well as perceptions of both the mitigation and prevention of occupational injuries among paramedics working for KwaZulu-Natal (KZN) Emergency Medical Rescue Services (EMRS). Methodology: The study adopted a quantitative, descriptive, cross-sectional approach. The study population comprised operational paramedics working for the KZN EMRS with a sample of 334 paramedics being drawn from a total of 2378 KZN EMRS paramedics. The study was conducted in five of the eleven districts in KZN. The data collection methods used included a closed ended questionnaire and a document review. The data which had been collected was analysed using Stata version 15. The Pearson chi-squared test was used to test for associations between any two categorical variables and, in instances, where Pearson chi-squared test was invalid Fisher’s exact test was used. A p-value of less than 0.05 was considered to be statistically significant. Results: Two of the five districts provided the required information for reviewing the records. A total of 36 injuries were reported in the two districts between 2011 and 2018. The reported injuries included injuries from motor vehicle accidents (61%), musculoskeletal injuries (16.7%), needle-stick injuries (13.9%), accidental surgical blade cuts (5.6%) and assault injuries (2.8%). A total of 152 survey questionnaires were completed and returned – a 45% response rate. The findings from the selfadministered questionnaire revealed 25 (16.5%) unreported injuries which included musculoskeletal injuries (48%, n = 12), needle-stick injuries (48%, n = 12), and one (1) (4%) assault-related injuries. A further 49 (32.2%) injuries which had resulted in medical attention being sought included musculoskeletal injuries (55.1%, n = 27), injuries due to motor vehicle accidents (44.9%, n = 22), needle-stick injuries (26.5%, n = 13) and assault-related injuries (8.2%, n = 4). Overall, 59 (38.8%) paramedics had experienced occupational injuries (both reported and unreported). The paramedics’ perceived risk factors for occupational injuries included high speed driving (87.5%, n = 133), violent members of society (87.5%, n = 133), heavy objects and patient lifting (86.2%, n = 131), physical exhaustion (78.3%, n = 119), hazardous material (77%, n = 117), and temperature extremes (73%, n = 111). In addition, the paramedics’ perceptions regarding occupational injury prevention revealed the following precautions, namely, avoiding high speed driving (79.6%, n = 121), specific positioning during equipment and patient lifting (63.8%, n = 97), avoiding chaotic scenes (61.8%, n = 94) and avoiding working longer hours (49.3%, n = 75). Conclusion: While it may be anticipated that information regarding occupational injuries suffered by paramedics would not be public knowledge, access to this information for purposes of research that aim to establish mitigation and prevention strategies, should be subjected to fewer challenges. From the data that was available, paramedics from KZN EMRS experienced multiple types of occupational injuries from a variety of injury sources. These injuries could be a result of both, the nature of the work and environment in which paramedics operate. However, further research is necessary to identify and validate these findings, as well as presented strategies required to minimise the rates of occupational injury among paramedics working for KZN EMRS.
Risks, prevalence and management of carpal tunnel syndrome amidst Somatologists within the Western Cape
(2020-11-30) Kistoor, Charne; Brooks, N.; Rammanhor, K.
Carpal Tunnel Syndrome (CTS) has been recognised for many decades across various industries and researched extensively in these domains. The practice of Somatology has greatly evolved from the beauty therapy industry of past years that simply focussed on aesthetic techniques of beautifying clients. The new techniques and general physical demands of the somatologist profession, however, raise concerns for the health and wellness of the somatologist. This research was motivated by the lack of data available on musculoskeletal disorders generally, and specifically, the prevalence among somatologists in the Western Cape of carpal tunnel syndrome. The study objectives were to determine the general prevalence of CTS among qualified somatologists in the Western Cape, to identify risk factors that contribute to the development of CTS in somatologists, and to determine current preventative measures and management of CTS among somatologists. A quantitative research approach was used to evaluate the objectives by collecting the data, using a questionnaire as the research tool. Various beauty schools and businesses within the field were contacted to determine the prevalence rate of qualified somatologists being diagnosed with CTS. A sample group of somatologists who had worked or were working in the Western Cape was recruited to the study and the questionnaire included openended questions to elicit more detailed responses beyond the statistical data. The results of the study indicated CTS is generally prevalent in the beauty therapy industry and has debilitating long-term consequences for the health and career longevity of somatologists, many of whom have to prematurely leave their chosen career paths due to their development of CTS, or to divert income to treatment costs in an industry where earnings are typically low. The study highlighted several issues that require further and wider study, such as compensation for injury, access to medical aid or employer subsidies, inherent health risks in the nature of some treatments and the need for more education and possible adjustments to training to prevent or alleviate the onset of CTS. Such future studies should provide insight for companies within the industry to aid their revision of policies and procedures to better facilitate and support somatologists suffering from CTS.
The epidemiology of musculoskeletal injuries in ringball players in KwaZulu-Natal
(2020-06-10) Wiggill, Johan Adriaan; Pillay, Julian David; Mkhwanzi, Blessing Nkazimulo
Background: Ringball is closely examined and compared to basketball and netball due to the fact that ringball is derived from those two sports (Gubby and Wellard, 2015), although the biomechanics differ from one another. This may expose players to different factors that can cause various injuries. Identifying the risk factors such as age, weight, height, warming up or not warming up before practice or competitive games etc. (Sinclair et al., 2014: 31-36; Murphy et al., 2003: 15; Russell, 2015), may help us understand, identify, prevent and manage injuries sustained during play. There are similarities of the injuries sustained between basketball and netball, however, the most common and least common injuries may be different. Aim and Objectives: The aim of this study was to profile musculoskeletal injuries of ringball players in KwaZulu-Natal. The objectives of this study were: to determine the period prevalence of musculoskeletal injuries in ringball players; to profile different types of musculoskeletal injuries in terms of location and severity; to determine the mechanisms and selected risk factors (e.g. age, height, protective gear, warming up etc.) of the injuries; and to determine the manner in which participants manage their musculoskeletal injuries sustained. Method: The research design was a quantitative paradigm, cross-sectional descriptive survey, using a structured questionnaire. The questionnaire was administered to 110 male and female ringball players in KwaZulu-Natal. Data from the questionnaire was statistically analysed using the IBM Statistical Package for the Social Sciences (SPSS) package (version 25) with a p-value of  0.05 indicating statistical significance. The data was described using frequencies and percentages for categorical variables and means and standard deviations for continuous variables. In order to assess associations between risk factors and injury, a Pearson’s chi square test was performed for categorical risk factors, and t-tests were performed for continuous variables. Results: A target population of 110 was calculated from a total of 152 players. The target population included male and female ringball players who were 16 years and older. Of the 110 questionnaires administered, 76 ringball players completed the research questionnaire. This resulted in a response rate of 69.1%. The prevalence of at least one injury, after at least one season played, in ringball players was 80.3% (n= 61). The most commonly reported location of injuries was foot/ankle injury at 35.5% (n= 33), followed by knee injury at 29% (n= 27) and wrist injury at 8.6% (n= 8). The most common mechanism of injury that was reported was landing 15.3% (n= 9), jumping 8.5% (n= 5), goal shooting 6.8% (n= 4), defending 6.8% (n= 4), collision 6.8% (n= 4), and other mechanisms 6.8% (n= 4). The participants reported that the most common healthcare professional utilised in general was self-treatment followed by no treatment. Only after the participants’ first injury, was there an indication of use of healthcare professionals such as physiotherapists, chiropractors and general practitioners. Furthermore, significant association between injury and not warming up before training (p-value of 0.013) and competitive matches (p-value of 0.044) was found. Discussion: This study revealed that ringball shares many similarities to basketball and netball (for example: the most common location of injury was the foot/ankle and knee). Mckay et al., (1996), reported minor differences between their study. and this one.Mckay et al., (1996) reported that the hand was the second most commonly injured area, whereas this study reported that the knee was the second most commonly injured area. This study reported that the foot/ankle, knee and wrist were most commonly injured. The results showed that there was a lack of primary healthcare professionals at competitive matches and training sessions. Primary healthcare professionals are needed at the relevant matches and training sessions so that the players can receive adequate treatment and management/treatment protocols since most of the ringball players reported that they received no treatment or applied self-treatment. This study also highlights the fact that coaches and players should pay special attention to warming up before any competitive match and training session since not doing so before training and competitive matches was a significant finding that was associated with injury. Conclusion: Over the last decade, ringball has emerged as a popular sport played across South Africa as well as internationally. The combination of the sport’s uniqueness and similarities to other sport provides an interest platform for new research, particularly in terms of injuires, as highlighted in this study.
The epidemiology of low back pain in male adolescent field hockey players in the eThekwini municipality
(2019-09-05) De Wit, Dale Cameron; Pillay, Julian David; Ducray, Jennifer Frances
Background: Field hockey is a popular international sport which is played in 132 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk for pain and injury to the lumbar spine. Due to the popularity of the sport of field hockey more empirical randomised controlled studies and/or observational studies need to be conducted to determine the pathomechanics of the nature of lower back pain and injury among players. Objectives: The objectives of this study were to determine the prevalence and incidence of low back pain in male adolescent field hockey players; to determine the characteristics of the low back pain in terms of location, chronicity, disability and treatment sought; and to determine the selected risk factors (demographics, equipment, health and lifestyle) of low back pain in male adolescent field hockey players. Method: A descriptive study of cross-sectional design, using a survey data collection tool was used on 112 male adolescent field hockey players in the eThekwini Municipality. The questionnaire data were then statistically analysed using IBM SPSS version 25 with statistical significance set at p value <0.05. Descriptive statistics such as mean and standard deviation, or median and inter-quartile range were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi square test and t-tests as appropriate. Results: A total of 68 participants completed and returned their questionnaires yielding a participation rate of 60.7%. The period prevalence of low back pain was 63.2% and the incidence was 38.2%. Point prevalence at the beginning of the season, mid-season, and end of season was 25%, 32.4% and 22.1% respectively. The most common location for low back pain was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their low back pain. The results were found to be statistically significant between hydration and low back pain (p = 0.050) i.e. those individuals who did not hydrate frequently during matches and training were significantly more likely to experience low back pain. Conclusion: Low back pain in male adolescent field hockey players is a common phenomenon. The results of this study, although limited to a select group of adolescents, showed a slightly higher prevalence of LBP to that of previous studies. More importantly, even though most participants did not experience low back pain classified as a disability, low back pain still had a large impact on participants, as nearly half of participants consulted with a medical professional for treatment. The study further indicates the need for frequent hydration during matches and training as inadequate hydration was found to be significantly related to low back pain. We highlight this as a novel finding and recommend special consideration to this by athletes and coaches. Moreover, the need for the development of strategies in the prevention and management of low back pain in field hockey is further recommended.
Back pain and its relationship to socio-demographic and psycho-social factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality
(2019) Hawker, Carmen; O'Connor, Laura
Background: The prevalence of back pain and general discomfort is not uncommon in pregnant women, often being under-reported until it affects their daily routine. South Africa, a third world developing country has unique risk factors and demographic profile. Although many studies have previously studied the various factors relating to back pain in pregnancy, this topic is far from being exhausted as a research area. Specifically, new studies should be conducted on the prevalence of back pain in pregnancy to analyse the impact it has on women worldwide. Little research has been conducted on rural communities in Africa especially in South Africa, to assess the risk of pregnancy-related back pain. Therefore, the information obtained from this study will provide a better understanding of the demographics, physical demands and psycho-social stresses experienced by pregnant women in this understudied population. Back pain and general discomfort is not uncommon in pregnant women, but it is often under- reported and can be disabling. International studies report a high prevalence especially in the last trimester. Little is known about the prevalence of and risk factors for back pain in South African pregnant women. Thus, this study aimed to determine the relationship between socio-demographic and psychosocial factors in a cohort of pregnant women attending a primary health care clinic in the eThekwini municipality of the province of KwaZulu-Natal, South Africa. Method: A retrospective descriptive cohort design was utilized whereby 382 participants’ files were assessed for eligibility. The files consisted of a socio-demographic questionnaire, a chart review and two epidemiological questionnaires that were administered to the participants during the first and third trimester. Permission to access these files was obtained from the principle investigator of the MRC/DUT project. All participants signed consent forms for research purposes. The data relevant to this study was extracted and analysed using Statistical Package for the Social Science version 24.0 (IMB Analytics). Descriptive statistics were used to describe the data in terms of means and standard deviations or frequencies and count where appropriate. Inferential statistics allowed for relationships between the variables to be assessed. A p - value of less than 0.05 was used to indicate statistical significance. Results: The total of 303 files were included. Participants were Black Africans, mostly single (81.2%, n=229) with a mean age of 25.84 (±SD 6.04). There was a high unemployment rate (70.8%, n=199), with most having obtained a secondary education (77.1%, n=213), and 44.1% (n=122) residing in squatter camps. There was a high human immunodeficiency infection rate (40.5%, n=94). Of the 303 participant files eligible for the study only 46 returned for the third trimester follow up. The prevalence of BP in the first trimester was 12.4% (n=35) and 10.9% (n=5) in the third trimester. LBP was the most (8.5%, n=24) in the first and 10.9% (n=5) in the third trimester, followed by UBP and NP. The incidence of back pain over the duration of pregnancy was zero. Being single (p = 0.03), reporting no stress (p = 0.04), not using pain killers (p = 0.01), and no alcohol consumption in the current pregnancy (p = 0.03) were associated with a decreased risk of back pain. There were no relationships found between the variables and back pain prevalence in the third trimester. Conclusion: The women attending this primary health care clinic are relatively young, come from a low socio-economic area with low reported levels of stress and substance abuse. They reported low levels of back pain. The follow up rate at the third trimester was low and this may skew the results of this study. Further research is needed in this community and South Africa to appreciate the prevalence and impact of back pain in pregnancy.

Faculty of Health Sciences

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