Fake news and fallacies : exploring vaccine hesitancy in South Africa

Historically, vaccine hesitancy (VH) has been a thorn in the side of public health efforts to contain and eradicate infectious diseases. This phenomenon is magnified in light of the current coronavirus disease 2019 (COVID-19) pandemic. Surveys conducted across South Africa since the outbreak of COVID-19 demonstrate the complexity of factors that contribute towards VH in this population. Amidst the negative press that the COVID-19 vaccine has received, especially across social media, understanding and combatting VH remains important to achieve herd immunity. This article aims to shed light on key factors fuelling COVID-19 VH in South Africa and provides a framework from which to address this problem.The National Research Foundation of South Africa, the Fogarty International Centre (FIC), National Institutes of Health Common Fund, Office of Strategic Coordination, Office of the Director (NIH CF/OSC/OD), Office of AIDS Research, Office of the Director (OAR/OD/NIH), National Institute of Mental Health of the NIH (NIMH/NIH).https://safpj.co.za/index.php/safpjMedical Virolog

An investigation into the relationship between the number of available generics within a therapeutic class and prices of medicines in South Africa.

M. Pharm. University of KwaZulu-Natal, Durban 2013.Abstract available in PDF file

A pandemic guided by the SARS-CoV-2 PCR test : what should the clinician know?

Amidst an ever-evolving pandemic, the demand for timely and accurate diagnosis of coronavirus disease 2019 (COVID-19) continues to increase. Critically, managing and containing the spread of the disease requires expedient testing of infected individuals. Presently, the gold standard for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains the polymerase chain reaction (PCR) test. Potential vulnerabilities of this testing methodology can range from preanalytical variables to laboratoryrelated analytical factors and, ultimately, to the interpretation of results.https://www.safpj.co.zaam2023Medical Virolog

Antibiotic use amongst pregnant women in a public hospital in KwaZulu-Natal

Background: Antibiotics are amongst the more frequently prescribed medicines in pregnant women and the use of antibiotics is increasing. However, with limited studies available in this population, the safe use of antibiotics in pregnancy remains a concern. Aim: To evaluate the use of antibiotics amongst pregnant women attending a public health care facility. The main objective of this study was to quantify the types of antibiotics used in pregnant women. Setting: A public hospital classified as a referral hospital located in Durban, KwaZulu-Natal. Methods: Demographic and treatment information of women were collected retrospectively from January 2019 to July 2019. A total of 184 pregnant patients, who received antibiotic therapy, were included in this study. Descriptive and analytical measures were used to analyse both patient demographics and treatment variables. Results: A total of 416 antibiotic prescriptions, issued to 184 patients, were reviewed. Penicillins (39.7%), macrolides (13.0%) and combination penicillin- and beta-lactam inhibitors (12.3%) were reported as the most commonly prescribed antibiotics. Rifamycin (2.9%), hydrazides (2.2%) and aminoglycosides (1.9%) were less frequently prescribed. Most antibiotics were prescribed for diseases of the circulatory system (36.1%). Conclusion: Several classes of antibiotics were used in pregnancy despite the lack of available safety data and clinical evidence. Informing women of the potential side effects and keeping abreast with new information played an important role in the safe, rational and effective use of medicines that contributed to improving maternal health

Assessing Knowledge of Community Pharmacists on Cancer: A Pilot Study in Ghana

Background: GLOBOCAN estimates that 16,600 cases of cancer occur annually in Ghana. Community pharmacists are the first point of contact to the public due to their accessibility, wide spread and credibility. They are often looked upon to provide first aid and treatment of common illness. They provide health information and support on diseases, e.g., cancer. Their role also extends to the patients' relatives. Thus, the level of knowledge and awareness of community pharmacists are of paramount importance in order to assure best healthcare advice is provided to the public. Goals of this pilot study were; (1) to collect a preliminary data on knowledge of risk factors, signs, and symptoms of cancer, (2) to ascertain the adequacy of the research survey in determining their level of knowledge, (3) to assess the viability of a full-scale study on community pharmacists.Methods: A cross-sectional survey was conducted using a self-administered questionnaire to assess the knowledge of signs and symptoms and risk factors of cancer among 150 community pharmacists.Key Findings: Score for knowledge on cancer among community pharmacists indicated that 76.7% had poor knowledge. Responses of community pharmacists toward a list of warning signs and symptom of cancer indicated poor level of knowledge (82%). Community pharmacists recorded poor level of knowledge (65.3%) on causes and risk factors for cancer. Correlation analysis shows that age has a relation with level of knowledge on signs and symptoms of cancer.Conclusion: This pilot study provided a valuable data which indicated that community pharmacists in Ghana have poor level of knowledge on cancer. The findings obtained from the study agree with findings of other studies conducted in this area which suggest that survey instrument was adequate to assess the knowledge level of community pharmacist in Ghana. Though the response was low, data obtained indicate a viability and need of conducting a full-scale research in this workforce to get a better assessment of the level of knowledge of community pharmacists on cancer in Ghana

An assessment of the current level of implementation of the core elements of antimicrobial stewardship programmes in public hospitals in Ghana

Introduction. Antimicrobial resistance (AMR) is becoming a threat to global public health. Antimicrobial stewardship (AMS) programme (ASP) is one of the five strategic areas in the Ghana National Action Plan to fight this menace. Assessment of the core elements of ASP in a hospital setting has been identified as a pragmatic way of identifying the barriers and facilitators for its effective implementation. Method. The World Health Organization’s toolkit for assessment of the seven core elements of ASP in hospitals in low- and middle-income countries was used for this situational analysis of public hospitals in two regions of Ghana. The core elements included leadership commitment, accountability and responsibility, pharmacy expertise, AMS actions and interventions, education and training, and periodic monitoring and surveillance. Data collected using a checklist were imported into STATA version 14 for descriptive and bivariate analyses. Results. 15 public hospitals were assessed with the toolkit. Most of them were primary health care facilities (n=12, 80.0%), had bed capacities between 100 to 199 beds, less than fifty medical doctors (n=12, 80.0%), less than five pharmacists (n=10, 66.7%), and between 100 to 199 nurses. Performances in four out of the seven core elements were most deficient and they included leadership commitment, pharmacy expertise, AMS actions (interventions) implemented, monitoring and surveillance of antibiotic use and bacteria resistance rates. Pharmacist-led ASPs were also found to be associated with their formal training on AMS. Key barriers identified included lack of skilled human resources, lack of available time for AMS-related duties and poor laboratory infrastructure. Conclusion. There was sub-optimal performance for almost all the core elements of ASP in the public hospitals in Ghana hampered mostly by lack of skilled human and financial resources. Pharmacists must be empowered through formal training and certificate programs in infectious disease management and AMS principles and strategies to enhance their contribution towards ASPs in hospitals The results from this study should encourage nationwide assessment of ASPs across hospital settings in Ghana to better evaluate the level of their implementation and address potential barriers to guide AMS policies and ASP strategy development towards the fight against AMR

Appropriateness of surgical antimicrobial prophylaxis in a teaching hospital in Ghana : findings and implications

Background: Surgical site infections (SSIs) are among the most common infections seen in hospitalized patients in low- and middle-income countries (LMICs), accounting for up to 60% of hospital-acquired infections. Surgical antimicrobial prophylaxis (SAP) has shown to be an effective intervention for reducing SSIs and their impact. There are concerns of inappropriate use of SAP in Ghana and therefore our audit in this teaching hospital. Method: A retrospective cross sectional clinical audit of medical records of patients undergoing surgery over a 5-month duration from January to May 2021 in Ho Teaching Hospital. Data collection form was designed to collect key information including the age and gender of patient, type and duration of surgery, choice and duration of SAP. Data collected were assessed for the proportion of SAP compliance with Ghana standard treatment guidelines (STG) and its association with various patient, surgical wound and drug characteristics. Results: Of the 597 medical records assessed, the mean age of patients was 35.6± 12.2 years with 86.8% (n=518) female. Overall SAP compliance with the STG was 2.5% (n=15). SAP compliance due to appropriate choice of antimicrobials was 67.0% (n=400) and duration at 8.7% (n=52). SAP compliance was predicted by duration of SAP (pConclusion: SAP compliance rate was suboptimal, principally due to a longer duration of prescription. Quality improvement measures such as education and training of front-line staff on guideline compliance, coupled with clinical audit and regular updates, are urgently needed to combat inappropriate prescribing and rising resistance rates

A multicenter cross-sectional survey of knowledge, attitude and practices of healthcare professionals towards antimicrobial stewardship in Ghana : findings and implications

Antimicrobial stewardship (AMS) programs are part of the key activities that contribute to reducing antimicrobial resistance (AMR). Good knowledge, attitudes, and practices (KAP) among healthcare professionals (HCPs) are essential to improving future antimicrobial use and reducing AMR, which is a priority in Ghana. A multicenter cross-sectional survey was conducted in six public hospitals in Ghana among key HCPs to assess their level of KAP towards AMS using a validated self-administered electronic questionnaire. Data analyses included descriptive and inferential statistics using STATA version 14. Overall, 339 out of 355 HCPs responded to the questionnaire, giving a response rate of 95.5%. Most responders were nurses (n = 256, 78.2%), followed by medical doctors (n = 45, 13.3%). The study recorded both poor knowledge (8.9%) and practice levels (35.4%), as well as a good attitude (78.8%) towards AMS. Ongoing exposure to AMS structured training, exposure to continuous professional development training on AMS in the previous year, and the number of years of working experience were predictors of the HCPs’ level of knowledge (aOR = 3.02 C.I = 1.12–8.11), attitude (aOR = 0.37 C.I = 0.20–0.69) and practice (aOR = 2.09 C.I =1.09–3.99), respectively. Consequently, concentrated efforts must be made to address current low levels of knowledge and poor practices regarding AMS among HCPs in Ghana as part of ongoing strategies in the National Action Plan to reduce AMR