Percutaneous exposure incidents - prevalence, knowledge and perceptions of dental personnel and students at a dental training site in KwaZulu-Natal

Healthcare workers, including dental practitioners and dental students, are at risk of occupational exposure to blood-borne pathogens such as hepatitis B, C and HIV. The present study set out to determine the prevalence, knowledge, management and perceptions of percutaneous injuries among staff and students at a dental training institute in Durban, KwaZulu - Natal with a view to identifying policies aimed at reducing the incidence. The prevalence of percutaneous injuries experienced by dental staff and students from 2001 to 2011 was determined. The levels of knowledge and their management of percutaneous injuries were determined among current dental staff and students. The dental department sustained 40% of total Hospital injuries, and of these 76% were suffered by students and 24% by staff. 22% of the sample had sustained a percutaneous injury, and of these, 57% had endured more than one and 24%, three or more injuries. Most current respondents had reported the incident (81%) and had taken the initial dose of post exposure prophylaxis; however, only 22% had taken the medication for the recommended period of four weeks. Avoiding percutaneous injuries by adopting safe work practices is probably the best practice to prevent transmission of blood-borne infections such as Hepatitis and HIV.DHE

Pathways to academic success of disadvantaged undergraduate university students from a high-risk community in the Western Cape

Academic success is an indicator of employability and a decreased susceptibility to poverty. South Africa is burdened by high levels of poverty, and low levels of academic achievement. Students in disadvantaged communities such as Delft, in South Africa, typically have poor academic outcomes, since it is linked to socioeconomic status. Despite the myriad of challenges that they encounter, some students from high-risk contexts attain academic success. This study explored the pathways to academic success of disadvantaged university students from a high-risk community in the Western Cape. This qualitative study used a narrative inquiry design. A sample of 10 (N =10) participants were selected using criterion-based purposive sampling. Data were analysed using thematic analysis. The pathways to academic success have obstacles, but through positive developmental relationships, specific personal qualities, and motivation, the students achieved academic success. The correlation, significance, and impact of each pathway on academic success can be explored further

Human papillomavirus (HPV) vaccination of adolescents in the South African private health sector: Lessons from the HPV demonstration project in KwaZulu-Natal

In South Africa (SA), >4 000 women die annually of cervical cancer, a disease caused by the human papillomavirus (HPV). Infections caused by certain genotypes of HPV increase the risk of cervical cancer. HIV-infected women in particular are more likely to have persistent HPV infection, with higher-risk genotypes. In SA, two vaccines (HPV quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant (Gardasil) and HPV bivalent (types 16 and 18) vaccine, recombinant (Cervarix)) are currently registered for the prevention of HPV-related disease. In the past, there have been significant challenges to achieving high coverage and uptake of vaccination – contributory factors include cost and lack of awareness. An HPV demonstration project among schoolgirls in rural KwaZulu-Natal showed that high vaccine uptake is achievable. In 2014, the National Department of Health launched the national HPV vaccination programme among female learners attending public schools. Awareness of HPV vaccination among healthcare providers, education of parents, teachers and learners, and avoidance of missed opportunities for vaccination are vital to the success of the programme. Primary healthcare practitioners may play an important role in cervical cancer prevention by identifying and offering vaccination to girls who miss the opportunity to be vaccinated at school. HPV vaccination should be considered as one arm of a comprehensive programme of cervical cancer prevention and control

Optical products for refractive error and low vision

This article will focus on the optical products required for the efficient delivery of refractive error and low vision services, and provide insight into how they can be managed effectively to ensure a quality service. You can consult the IAPB Standard List (see page 30) for suggestions regarding the optical products you may require at your facility as well as recommended suppliers

An epidemiological perspective of substance use among high school pupils in rural KwaZulu-Natal

Objectives. To investigate prevalence and the factors influencing substance use among rural high school pupils in KwaZulu-Natal in order to develop and implement intervention programmes.Design. Cross-sectional study.Setting. Twenty-eight high schools in southern KwaZulu-Natal.Subjects. One thousand three hundred and eighteen grade 10 pupils.Outcome measures. An anonymous self-reporting questionnaire was used to investigate the use of alcohol, tobacco (cigarettes), cannabis and solvents.Results. Of the male scholars, 52.9% (95% confidence interval (CI): 45.4- 60.3) reported ever using alcohol, 16.9% (CI: 11.5 - 24.0) reported using cannabis, and 13.1% (CI: 7.2 - 22.5) had smoked more than one cigarette daily. Among male pupils 45.5% (CI: 38.6- 52.6) had inhaled benzine and 34.6% (CI: 28.0- 41.8), thinners; 7.4% (CI: 3.4 - 15.2) had used cocaine and 4.1% (CI: 1.0 - 10.6), crack. Female pupils reported significantly less use of alcohol (25.5%, CI: 17.6 - 35.3), cannabis (2.3%, CI: 1.3 - 4.1), cigarettes (more than one daily) (2.0%, CI: 1.0 - 4.1), and inhalation of benzine (18.8%, CI: 13.8 - 25.2) and thinners (10.8%, CI: 7.2 - 16). Logistical regression indicated that the odds of smoking cigarettes increased significantly (p < 0.0005) with use of the other substances.Conclusion. The results of this study confirm the prevalence of multi-substance use among pupils at the majority of rural high schools in this district and the need for targeted interventions to reduce/prevent this

Nuchal translucency as a method of first-trimester screening for aneuploidy

Objective. To determine the effectiveness of nuchal translucency (NT) screening in predicting aneuploidy and structural abnormalities in a South African population. Study design. Descriptive study. Setting. Chris Hani Baragwanath Hospital fetal medicine unit. Outcome measures. An adjusted risk was derived from the combination of maternal age-related risk and the risk derived from NT screening. A positive screen was denoted by an adjusted risk of more than 1/300 and a negative screen by an adjusted risk of less than 1/300. In order to determine the number of undiagnosed abnormalities in the group, all babies were examined by a paediatrician at birth to detect and describe dysmorphic features. Results. A total of 428 patients underwent first-trimester screening between July 2003 and July 2005. Three per cent were lost to follow-up. Of the 415 patients analysed, 59 screened positive and 356 screened negative. The mean age for both groups of patients was 30.1 years. Of the 57 patients who screened positive, 24 elected to have chorionic villus sampling (CVS). This resulted in the detection of 6 chromosomal abnormalities and 2 structural abnormalities. Among the remaining 356 patients, who had screened negative, 2 had an increase in the adjusted risk when the risk was compared with the background risk, and 1 chromosomal abnormality was detected in this group; 8 elected to have CVS because of a previous history of a chromosomal abnormality, and there were no abnormalities among them. Conclusions. The use of these screening methods has enabled prenatal karyotyping to become cost effective, and allows concentration on pregnancies at highest risk for chromosomal abnormalities, regardless of age.South African Medical Journal Vol. 98 (4) 2008: pp. 295-29

Blood pressure control at a hospital day clinic - a medical audit

Aims. To examine prescribing habits and blood pressure control in a hospital day clinic population receiving calcium channel blockers.Setting. King Edward VIII Hospital day clinic, Durban, KwaZulu-Natal.Patients. 200 consecutive patients receiving a regimen containing calcium channel blockers. 190 patients with evaluable data.Method. Automated non-invasive Dinamap recording) of blood pressure.Results. Only 27% of patients had a blood pressure under 140/90 mm/Hg. Control was unsatisfactory in 53% of patients (blood pressure > 160/95 mmHg), despite the fact that they were attending a hospital-based day clinic. At least 2 agents were used in 93% of patients. Diuretics (62%) and angiotensin-converting enzyme inhibitors (59%) were the most frequently prescribed agents in addition to calcium channel blockers. Subjective side-effects were few and related to vasodilator therapy.Conclusion. The study supports findings worldwide that blood pressure control tends to be poor. Several reasons for poor control were noted. The results raise many important questions regarding management of hypertension