Prevalence and patterns of medication use in children and adolescents with Autism Spectrum Disorders in the Western Cape

Includes abstract.Includes bibliographical references.The Autism Spectrum Disorders(ASD) are a group of neurobiological conditions of growing prevalence for which there is no known cure. International prevalence studies have determined that children and adolescents with ASD are a highly medicated population. This comes to light in the context of a paucity of data around the efficacy of commonly prescribed medications. There is no data around the prevalence of medication use in the ASD population in South Africa. The aim of this study is to determine the prevelance and patterns of medication use in children and adolescents with ASD in the Western Cape and to determine the relationship between demographic variables and behaviours and medication use

Correlates of Emotional and Behavioural Problems in Children with Perinatally Acquired HIV in Cape Town South Africa

In the antiretroviral era children perinatally infected with HIV (PHIV+) are surviving into adulthood and are at risk for emotional and behavioural problems. Few studies of these problems have been conducted in low and middle income countries (LMIC) and even fewer in sub - Saharan Africa where the burden of the HIV epidemic remains heaviest. The aims of this study were to provide a quantitative description of emotional and behavioural problems in a group of children and adolescents with perinatally acquired HIV in South Africa compared to a group of well - matched HIV - negative controls and to identify demographic, biological, cognitive and contextual correlates of emotional and behavioural problems. A cross-sectional descriptive, analytical study was conducted. Participants were recruited from community and hospital based clinics. Wi thin the HIV - infected group, children were further divided into three subgroups: PHIV+ children who had never been on antiretroviral therapy (ART naïve), PHIV+ children on ART and PHIV+ children on ART with a confirmed diagnosis of HIV - related encephalopathy (HIVE) . Emotional and behavioural problems were assessed using the Child Behaviour Checklist (CBCL). Several measures were used to assess demographic, biological, cognitive and contextual correlates of problem behaviours: socio - demographic questionnaire, clinic records, neuropsychological test battery, Family Resource Scale, Family Support Scale and Center for Epidemiologic Studies - Depression Scale. Children were compared by HIV status on demographic, cognitive and contextual variables as well as the total and subscale scores of the CBCL. Multivariate comparisons of the influence of contextual and cognitive variables on CBCL total problems was performed using a hierarchical step - wise linear regression analytic procedure. The final sample (N=108) for data analysis included 78 PHIV+ children and 30 HIV - negative children. Groups were comparable with respect to demographic and contextual variables. Cognitive performance scores were significantly lower in the PHIV+ children when compared to HIV - negative controls (p<0.001). Rates of caregiver depression were higher in both groups than the lifetime prevalence rates reported in the South African population

Methods of deliberate self-harm in a tertiary hospital in South Africa

CITATION: Pieterse, D. et al. 2020. Methods of deliberate self-harm in a tertiary hospital in South Africa. South African Journal of Psychiatry, 26:a1399, doi:10.4102/sajpsychiatry.v26i0.1399.The original publication is available at https://sajp.org.zaBackground: Little is known about the methods of deliberate self-harm (DSH) in South Africa (SA), despite the importance of means restriction as a public health strategy to reduce the morbidity and mortality associated with self-harm. Aim: The aim of this study was to investigate the range of methods used in DSH and identify the socio-demographic and clinical factors associated with violent and non-violent methods of DSH among patients treated at a tertiary hospital in SA. Setting: The study was conducted at an urban, tertiary level emergency department at Groote Schuur hospital in Cape Town, South Africa. Method: Data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Logistic regression models were used to explore the factors associated with violent and non-violent methods of DSH. Results: Self-poisoning was the most common method of self-harm (80.3%). Prescription medication was the most common form of self-poison (57.6%), while a large number of patients used non-prescription paracetamol (40.9%). In the regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH. Conclusion: Improved monitoring of prescription medications commonly used in DSH is integral to public health suicide prevention strategies in SA. This study underscores the need for substance use interventions in the healthcare setting.South African Medical Research Councilhttps://sajp.org.za/index.php/sajp/article/view/1399Publisher's versio

“So, you must understand that that group changed everything”: perspectives on a telehealth group intervention for individuals with chronic pain

Background The Patient Education Empowerment Programme (PEEP) is an interdisciplinary group intervention for people living with chronic pain. As a result of the COVID-19 pandemic, lockdown and restrictions on in-person group-based health care delivery in South Africa, PEEP was modified to a telehealth electronic format (ePEEP) and offered to patients on a waiting list at two interdisciplinary chronic pain clinics in Cape Town, South Africa. The purpose of this study was to explore the feasibility and acceptability of ePEEP through the perspectives of individuals with chronic pain who participated in ePEEP.  Methods A qualitative, exploratory descriptive study was conducted. One month after completion of the 6-week ePEEP programme, individuals who participated, were recruited for the study. Data were collected through semi-structured interviews. Data analysis followed an iterative process of inductive content analysis.  Results Six individuals, all women, consented and participated in the study. Three main themes emerged from the data. Theme one focussed on how ePEEP initiated a journey of personal development and discovery within the participants. In theme two, participants reflected on the importance and value of building peer and therapeutic relationships as part of ePEEP. In theme 3, participants shared that the online learning environment had features which influenced learning about pain in different ways. Conclusion ePEEP was found to be acceptable, feasible and valuable for the participants. ePEEP facilitated self-discovery, empowerment, relationship building and transformation in the participants, through experiential learning. Although barriers and facilitators to learning were present, both enhanced the learning experience. The positive reception of this telehealth initiative indicates potential for enhanced access to chronic pain management services in the South African setting

Prevalence and patterns of medication use in children and adolescents with autism spectrum disorders in the Western Cape, South Africa

Objective: This study was conducted to investigate the prevalence and patterns of medication use amongst a sample of school going children and adolescents with autism spectrum disorders (ASD) in the Western Cape, South Africa.Method: This was a descriptive, quantitative, analytic study. A survey questionnaire and the Nisonger Child Behaviour Rating Form (NCBRF) were administered to parents of children and adolescents recruited from two schools for children with ASD in Cape Town and from the Autism Action database.Results: A total of 24.6% of the 65 children used psychotropic medications. Antipsychotics were the most common reportedly used psychotropics followed by stimulants, antidepressants and mood stabilisers. Complementary and alternative medications were also commonly used with 40% of children using over the counter medications (OTC) and 15.4% being on a special diet for autism. Children of black African or coloured ethnicity were less likely to use OTC medication than children in the white/Asian ethnic group.Conclusions: In keeping with international studies this sample of children with ASD was a highly medicated group. The findings of this pilot study were limited by the response rates and sample size, but provide valuable insight into medication use in the South African ASD population.Journal of Child and Adolescent Mental Health 2013, 25(1): 69–7