The role of socio-economic position on satisfaction with oral health services among South African adults : a structural equation model

OBJECTIVE : To investigate how differences in socio-economic position (SEP) influence satisfaction with dental services among South Africans. METHODS : Data collected from a nationally representative sample of the South African population ≥16 years old (n=3,112) included socio-demographics, health insurance enrolment, past-year dental visit and facility type (public or private), satisfaction and reason(s) for dissatisfaction with the dental services received. Using structural equation modelling, a pathway to satisfaction with dental services was tested using a number of model fit statistics. RESULT : Of the 15.1% (n=540) who had visited a dentist in the past-year, 54.1% (n=312) were satisfied with the services received. Reasons for dissatisfaction included long waiting time (33.1%), painful procedure (13%) and rude staff (10.4%). Being of higher SEP was associated with reporting using private facility. Those who visited public facilities were more likely to have encountered a long waiting time, which in turn was associated with being more likely to report treatment as having been painful and reporting dissatisfaction. Long waiting times had the greatest direct effect on dental service dissatisfaction (β = -0.31). CONCLUSION : Improving waiting time is likely to be the major factor to help reduce socio-economic disparities in the quality of dental services experienced by South Africans.http://www.sada.co.zaam2017Dental Management Science

Assessment of job satisfaction among dentists working in different settings in the Tshwane metro

INTRODUCTION: Job satisfaction of dentists is important, as dentists are critical in the delivery of comprehensive health care. Whilst job satisfaction among dentists has been widely investigated elsewhere, it is poorly researched in South Africa. AIMS AND OBJECTIVES: To assess job satisfaction among dentists working in Tshwane district. DESIGN: A cross-sectional study. METHODS: Data were collected using a self-administered, validated, modified questionnaire adapted from the Dentists' Satisfaction Survey. Demographic data and the responses associated with job satisfaction in various settings were collected. Two of the questions were qualitative and open-ended. Data were analysed using statistical software package (STATA) version 10. Ethical clearance was obtained and all data were anonymous. RESULTS: The response rate was 77% and 53 %( 41) of respondents were female. Perception of income, relationships with patients and personal time were significantly positively associated with job satisfaction. Patient happiness with treatment, the autonomy and flexibility of private practice and imparting knowledge also contributed to job satisfaction. Unrealistic expectations of patients, long working hours, restricted funding and lack of equipment contributed to job dissatisfaction. CONCLUSION: Overall the dentists were satisfied, however, satisfaction and dissatisfaction were conditional and influenced by factors such as perception of income and unrealistic patient expectations.https://www.sada.co.za/the-sadjam2020Community DentistrySchool of Health Systems and Public Health (SHSPH

Predictors of risk of alcohol-exposed pregnancies among women in an urban and a rural area of South Africa

The study sought to determine the prevalence and predictors of being at risk of an alcohol-exposed pregnancy (AEP) among women of child-bearing age in an urban and rural location in South Africa. We conducted a cross-sectional household survey of 1018 women aged 18-44 years in one urban (n = 606) and one rural (n = 412) site. The women were interviewed using a structured questionnaire. We defined the primary dependent variable, being at risk of having an AEP, as current alcohol use, not being pregnant, being fertile, and no effective use of contraceptives. The independent variables included demographic, substance use, health perceptions, psycho-social, and partner characteristics. The rural women (21.84%) were more likely than their urban counterparts (11.22%) to be at risk of an AEP. In multiple logistic regression analyses, significant predictors of being in the "at risk" group for the urban women were (a) being 'white' as opposed to 'black/African', and being 'coloured' as opposed to 'black/African'; and (b) current smoking. For the rural women, significant risk factors were (a) current smoking and (b) early onset of alcohol use. The significant protective factors were (a) education; (b) knowledge about Fetal Alcohol Syndrome; (c) parity. Use of stricter alcohol use criteria (i.e., three or more drinks and five or more drinks per sitting) in the definition of risk of an AEP yielded slightly different patterns of significant predictors. The results revealed high levels of risk of an alcohol-exposed pregnancy, especially amongst the rural women, and a need for location-specific prevention programmes. The high burden of AEP in South Africa calls for the establishment of national AEP prevention strategies and programmes as a matter of urgency.

Vector competence of <i>Glossina austeni</i> and <i>Glossina brevipalpis</i> for <i>Trypanosoma congolense</i> in KwaZulu-Natal, South Africa

Tsetse-transmitted trypanosomosis (nagana) has been the cause of stock losses in the recent past and still presents a major problem to livestock owners in certain areas of KwaZulu- Natal, South Africa. Over 10 000 cattle mortalities were reported in the 1990 nagana outbreak. Although information on the distribution and abundance of the tsetse flies Glossina brevipalpis and Glossina austeni in KwaZulu-Natal exists, data on their vector competence are lacking. This study aimed to determine the rate of natural Trypanosoma congolense infection by field-collected as well as colony-reared flies of these species. A total of 442 field-collected G. brevipalpis and 40 G. austeni flies were dissected immediately after collection to determine their infection rates, whilst 699 G. brevipalpis and 49 G. austeni flies were fed on susceptible animals in 10 and four batches, respectively, for use in xenodiagnosis experiments. Teneral colony flies were fed on infected animals and dissected 21 days post infection to confirm their infectivity testing. Glossina austeni harboured 8% immature and mature infections. In G. brevipalpis, the infection with the immature stages was lower (1%) and no mature infections were observed. Although all four batches of G. austeni transmitted T. congolense to four susceptible animals, no transmission resulted from 10 batches of G. brevipalpis fed on susceptible cattle. Colony-derived G. austeni (534) and G. brevipalpis (882) were fed on four bovines infected with different T. congolense isolates. Both G. austeni and G. brevipalpis acquired trypanosome infection from the bovines, with immature infection ranges of 20% – 33% and 1% – 4%, respectively. Parasites, however, only matured in G. austeni (average = 4%). Glossina austeni plays a larger role in the epidemiology of animal trypanosomosis in KwaZulu-Natal than G. brevipalpis and therefore more focus should be aimed at the former when control measures are implemented