Faculty of Health Sciences
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Item A qualitative investigation of facilitators and barriers to DREAMS uptake among adolescents with grandparent caregivers in rural KwaZulu-Natal, South Africa(Public Library of Science (PLoS), 2022) Gumede, Dumile; Meyer-Weitz, Anna; Zuma, Thembelihle; Shahmanesh, Maryam; Seeley, JanetAdolescents with grandparent caregivers have experienced challenges including the death of one or both parents due to HIV in sub-Saharan Africa. They may be left out of existing HIV prevention interventions targeting parents and children. We investigated the facilitators and barriers to DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) programme uptake among adolescents with grandparent caregivers across different levels of the socio-ecological model in rural South Africa. Data were collected in three phases (October 2017 to September 2018). Adolescents (13–19 years old) and their grandparent caregivers (≥50 years old) (n = 12) contributed to repeat in-depth interviews to share their perceptions and experiences regarding adolescents’ participation in DREAMS. Data were triangulated using key informant interviews with DREAMS intervention facilitators (n = 2) to give insights into their experiences of delivering DREAMS interventions. Written informed consent or child assent was obtained from all individuals before participation. All data were collected in isiZulu and audio-recorded, transcribed verbatim and translated into English. Thematic and dyadic analysis approaches were conducted guided by the socio-ecological model. Participation in DREAMS was most effective when DREAMS messaging reinforced existing norms around sex and sexuality and when the interventions improved care relationships between the adolescents and their older caregivers. DREAMS was less acceptable when it deviated from the norms, raised SRH information that conflicts with abstinence and virginity, and when youth empowerment was perceived as a potential threat to intergenerational power dynamics. While DREAMS was able to engage these complex families, there were failures, about factors uniquely critical to these families, such as in engaging children and carers with disabilities and failure to include adolescent boys in some interventions. There is a need to adapt HIV prevention interventions to tackle care relationships specific to adolescent-grandparent caregiver communication.Item The effect of migraine-type headaches on quality of life in an adolescent population in the Westville ward of the Pinetown School District(2022-05-13) Wurzel, Amy Jane; Varatharajullu, DesireeBACKGROUND Migraine-type headaches (MTHs) are the most common disabling disorder in children and adolescents, affecting approximately 10% of children and adolescents. Migrainetype headaches are common in children over the age of 14 years and the incidence peaks between the ages of 15 and 24 years. Migraine-type headaches affect many aspects of an adolescent’s life often leading to comorbid psychological issues such as anxiety and depression. The headaches also affect productivity and cause an increase in school absenteeism. AIM The aim of this study was to explore the effect of migraine-type headaches on the quality of life in an adolescent population in the Westville ward of the Pinetown School District. METHODOLOGY Data were collected through semi-structured interviews using a qualitative descriptive approach. Probing questions supplemented the main questions being asked. The interviews relied on the participants’ own perspective to provide insight into the effects of migraine-type headaches. Adolescents who met the inclusion criteria and agreed to participate in the study were interviewed. A minimum of 10 participants were required for this study. Data were collected until data saturation was obtained and, therefore, the total number of research participants who participated in the study was 14. The data were audio recorded and thereafter transcribed verbatim. Thematic data analysis was used to analyse the data using the Tesch method. RESULTS The participants explained that their migraine-type headaches affected their education, homework, concentration and/or chores. Some participants mentioned that they had to miss social events or cancel plans with friends, while others mentioned that it has affected their relationships with family and friends. Many participants mentioned that their MTHs affected them emotionally in some way and resulted in anger, frustration and/or worry. Most of the participants explained that their MTHs affected their extra-curricular activities, hobbies and general movement. CONCLUSION Migraine-type headaches have a negative effect on the quality of life in the adolescent population. This is consistent with similar studies done on migraine-type headaches in adolescent populations.Item 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 FrancesBackground: 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.