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Now showing 1 - 5 of 19

Recent Submissions

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Tobacco use among healthcare professionals and their readiness to implement cessation treatments among patients in Primary Care facilities in Soweto, Johannesburg
(University of the Witwatersrand, Johannesburg, 2024) Alagidede, Ann Nhawinei; Omole , Olufemi B.
Background: Despite its hampering influence on healthcare professionals’ (HCPs) willingness to implement tobacco cessation treatments (TCT), tobacco use remains understudied in South Africa. Objective: To determine the prevalence of tobacco use among HCPs and its influence on their readiness to implement TCT for their patients. Methods: This cross-sectional study sampled 444 HCPs in five Community health centres in Soweto. A self-administered questionnaire collected information on socio- demography, tobacco use, quit attempts and HCPs’ readiness to implement TCT for their patients. Readiness was defined as a construct of HCPs’ rating of the importance of TCT and their confidence in implementing it. Results: The mean participant age was 41 years. Most were female (80%;n=355), single (54.1%;n=240) and black (91.6%;n=405). About 22%(96) were ever-users of tobacco, 12.6%(n=56) current users and 9%(n=40) ex-users. Among current users, 64.3%(n=36) smoked only cigarettes, 17.9%(n=10) used only snuff, and 14.3%(n=8) used other products. About 56.6%(n=30) of current users had contemplated quitting in the past year. Approximately 68%(n=300) and 82.2%(n=365) of participants were ready and willing to implement TCT, respectively. Only 32%(n=143) and 25%(n=107) of participants had received any training on tobacco use and TCT, respectively. There was no significant association between tobacco use and readiness to implement TCT (p=0.50). Conclusion: Tobacco use is prevalent among HCPs and has no influence on the implementation of TCT in South African primary health care. Although most HCPs reported readiness and willingness, there is a need to scale up training, both during formal health professions education and in continued professional development. Contribution: This is one of few recent studies demonstrating the concerning rate of tobacco product use among HCPs in South African PHC. Although there is a high level of readiness to implement TCT for their patients, most HCPs still need training to ensure their self-efficacy.
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Laboratory Evaluation of Aspergillus Galactomannan Lateral Flow Assays
(University of the Witwatersrand, Johannesburg, 2023) Ubbink, Anja; Chibabhai, Vindana; Nana, Trusha
Background Invasive aspergillosis diagnosis is based on a combination of clinical, radiological, and mycological factors, including the detection of Aspergillus galactomannan antigen in serum and bronchoalveolar lavage fluid (BALF). Lateral flow assays (LFA) introduced for rapid detection of galactomannan in serum and BALF include the IMMY sōna Aspergillus LFA (IMMY LFA) and the Dynamiker QuicGMTM Aspergillus Galactomannan Ag LFA (QuicGM LFA). Objective To evaluate the performance of the IMMY LFA and QuicGM LFA in South Africa. Methods Serum and BALF samples previously tested by Platelia BioRad Aspergillus GM-EIA were analysed using the two different LFAs. Percentage agreement and precision was assessed. Results Forty-six serum- and 13 BALF samples were tested using the IMMY GM LFA and 48 serum- and 6 BALF samples were tested using the QuicGM LFA. Using an optical density ≥0.5 as positive, results were compared to the BioRad Aspergillus GM-EIA. For the IMMY LFA, serum samples had a positive percent agreement (PPA) of 0% (0/1); negative percent agreement (NPA) of 91% (41/45) and overall percent agreement (OPA) of 89% (41/46). BALF samples had a PPA of 75% (3/4), NPA 50% (5/10) and OPA of 57% (8/14). For the QuicGM LFA, serum samples had a PPA 0% (0/3), NPA of 96% (43/45) and OPA of 90% (43/48). BALF samples had a PPA of 100% (1/1), NPA of 100% (5/5) and OPA of 100% (6/6). For the IMMY LFA, between-day reproducibility for 72% (13/18) and 63% (5/8) for serum iii and BALF samples, respectively. Between-batch reproducibility was 89% (16/18) and 50% (4/8), respectively for serum and BALF samples. For the QuicGM LFA, between-day reproducibility was 75% (9/12) and 75% (3/4) for the serum and BALF samples, respectively. The between-batch reproducibility was 100% (8/8) for serum and 100% (3/3) for BALF. Conclusion A follow-up evaluation with a larger sample size utilizing clinical, radiological, and laboratory data is warranted to determine the assays’ clinical utility. What this study adds Invasive aspergillosis is a life-threatening disease, where a prompt diagnosis improves outcome. Currently there is no Aspergillus galactomannan assay available in the South African state sector. This study evaluates two lateral flow assays for the detection of Galactomannan in South Africa.
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The effect of Neodymium Yttrium Aluminium Garnet laser capsulotomy on intraocular pressure and retinal nerve fibre thickness
(University of the Witwatersrand, Johannesburg, 2024) Carey, Angelika Ursula; Ally, Naseer; Alli, Hassan Dawood
Purpose To study the effect of Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy on intraocular pressure (IOP) and retinal nerve fibre layer (RNFL) thickness in all patients and diabetic patients with post-cataract posterior capsule opacification (PCO). Design Prospective cohort study Methods In all the patients, including the diabetic patients, the IOP and RNFL were measured and the PCO graded before Nd:YAG laser capsulotomy (baseline), and the IOP measured at 15 minutes, 2 hours, 1 week and 1 month after laser capsulotomy. Additionally, the RNFL was measured at 1 month after laser capsulotomy. The IOP and RNFL at the aforementioned timepoints after laser capsulotomy was compared to the baseline IOP and RNFL in all patients and in diabetic patients. Results Compared to baseline there was a significant increase in IOP of 0.9mmHg at 2 hours (p = 0.01) after laser capsulotomy in all patients. In diabetic patients there was a significant increase in IOP of 1.58mmHg at 15 minutes (p = 0.01) and 1.21mmHg at 2 hours (p = 11 0.006). There was a significant decrease in the RNFL thickness in diabetic patients 1 month after laser capsulotomy (p= 0.009); there was no decrease in RNFL thickness in all the patients at this time point. Conclusion The prolonged (15 minutes to 2 hours) increase in IOP and the decrease RNFL thickness at 1 month in diabetic patients suggest that these patients are at increased risk of glaucoma. Further longitudinal studies are required to determine if diabetic patients develop glaucoma after Nd:YAG laser capsulotomy.
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South African HE Libraries as Catalysts for SDG Impact: Strategies for Access, Collaboration, and Societal Engagement
(University of the Witwatersrand, Johannesburg, 2025-08) Matizirofa, Lazarus Gallant
Higher Education Institutions (HEIs), libraries, Sustainable Development Goals (SDGs), and Artificial Intelligence (AI) is a nexus where innovation meets purpose.
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A randomised controlled trial comparing erector spinae and transversus abdominis plane blocks for postoperative analgesia after elective caesarean section
(University of the Witwatersrand, Johannesburg, 2024) Eksteen, Aidan; Wagner, Janine; Kleyenstuber, Thomas
Background Peripheral abdominal nerve blocks contribute to multimodal postoperative analgesia that enhances early recovery after caesarean sections. The transversus abdominis plane (TAP) block is an established technique that offers somatic abdominal analgesia. The erector spinae plane (ESP) block is a novel fascial plane block that may offer additional visceral analgesic effects. This study aimed to compare the postoperative analgesic efficacy of bilateral ultrasound-guided TAP blocks to ESP blocks in women undergoing caesarean sections under spinal anaesthesia Methods Sixty-six ASA grade 1-3 (≥18 years) patients undergoing elective caesarean section under spinal anaesthesia were randomly allocated to receive either TAP blocks (n =33) or ESP blocks at the T9 vertebral level (n =33). The primary outcome measure was 24-hour cumulative morphine consumption. The secondary outcomes included the time taken to perform blocks, numeric rating scale (NRS) pain scores at 6- and 24-hours, effect of pain on activities of daily living (ADLs) and care for the newborn, time to first analgesic request, severity of opioid-related side effects, and patient satisfaction. Results There was no statistically significant difference in mean (SD) 24-hour cumulative morphine consumption between the ESP blocks and TAP blocks: 27 mg (14) vs 32 mg (15) (p=0.185). ESP blocks took longer to perform: 10.7 minutes (2.2) vs 9.0 minutes (2.5) (p<0.01). There were no significant differences in the other secondary outcomes. Conclusion The TAP block and ESP block were equally effective for postoperative analgesia after elective caesarean section under spinal anaesthesia. The ESP block did not demonstrate significant additional visceral analgesic effects.