The association between HIV tri-therapy with the development of Type-2 Diabetes Mellitus in a rural South African District: A case-control study

BackgroundCombination antiretroviral drugs (cARVs) prolong patients' lives but are unfortunately thought to increase complications related to metabolic disorders including type-2 Diabetes Mellitus (DM). We sought to confirm the association of cARVs with type-2 DM and ascertain the extent of this association in a rural South African setting.MethodsA case-control study of 177 (33.33%) cases with HIV/AIDS and type-2 DM were selected and compared with 354 (66.67%) non-DM HIV/AIDS unmatched controls from a rural district of South Africa's third most populous province (Eastern Cape). Cases were identified from community health centres using the district health information system, and controls were identified using simple random sampling from the same health facilities. Odds Ratios (OR), together with 95% confidence intervals, were calculated for all the univariable and multivariable logistic analyses.ResultsThis study found that cARVs significantly increased the occurrence of type-2 DM among HIV patients. Patients on protease inhibitors (PIs) were at least 21 times significantly (pConclusionThis study has been able to establish the association between cARVs and type-2 DM. It therefore proposes consideration of the usage of AZT, D4T, lopivavir and ritonavir for the treatment of HIV. The study further proposes more prospective research to test these findings further

Understanding the motivations for COVID-19 vaccine hesitancy in South Africa: Narrative literature review

While efforts to promote vaccine knowledge and acceptability in the global and local communities are applauded, affordability of the vaccines to the public is inadequate thus strategies that promote vaccine access and uptake will lead to increased usage of COVID-19 vaccines. To review the relevant literature obtained from a computerised database search that focuses on vaccine hesitancy in order to understand motivations for vaccine hesitancy with a view to address within a South African context. A comprehensive search from different databases, namely, Google Scholar and North-West University Library through the e-Link Catalogue, with journal and conference publications from 2010 to 2021, yielded qualitative, quantitative and mixed-method studies that addressed various topics on vaccine hesitancy. Inclusion and exclusion criteria were set and 25 publications met the inclusion criteria for the review. The motivations for COVID-19 vaccine hesitancy are described as complacency: anti-scientific attitude (unbelief in evidenced-based information) caused by conspiracy beliefs and distrust in information sources leading to lack of compliance to COVID-19 restrictions such as wearing of masks, social distancing and lack of hand hygiene: convenience/lack of access to COVID-19 vaccines; caused by delays in the distribution and use of vaccines till expiry dates were reached and lack of confidence and trust: caused by concerns on safety and effectiveness of vaccines. COVID-19 vaccine hesitancy can be addressed by ensuring that there are no constraints related to the supply and system that administers vaccines; building trust in the safety of vaccines, health services and government authorities and avoiding delays in distribution and use of vaccines. Future studies need to address the root causes of conspiracy beliefs that lead to complacency (anti-scientific attitudes) resulting in delays/refusal of COVID-19 vaccines and noncompliance to evidence-based information that if observed could curb the spread of COVID-19

Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent. Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered. Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data. Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes. Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context