Electronic Theses and Dissertations (Masters)

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Browsing Electronic Theses and Dissertations (Masters) by Author "Kabudula, Chodziwadziwa"

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    A visual analytics approach to characterising disease progression among adults with chronic diseases in rural Agincourt northeast South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Nhlapho, Mapule Dorcus; Kabudula, Chodziwadziwa
    Chronic diseases pose a significant challenge to the healthcare systems in South Africa, calling for innovative approaches for comprehensive understanding and management. This research study utilizes the Agincourt HDSS-Clinic dataset to design and implement a visual analytics system using the R Shiny web application framework. Focused on adults with chronic diseases, the tool employs dynamic visualizations to show patterns of healthcare utilization and disease progression. Through the R Shiny platform, the system provides a user-friendly interface for exploring and interpreting complex data, offering valuable insights into patient healthcare behaviours and the dynamics of chronic illnesses. The study used data from a total of 26 426 patients consisting of 19 265 (73%) females and 7 161 (27%) males. The study revealed previously unrecognized associations between specific chronic conditions including the existence of a substantial intersection between HIV, Hypertension, and Diabetes with 101 patients experiencing the coexistence of all the three conditions. Notably, the visual analytics system facilitated the identification of distinct healthcare utilization patterns across different demographic groups highlighting the most frequently visited health facility accounted for 5 912 patient visits overall while the least visited health facility accounted for 1 447 patient visits. The findings underscore the effectiveness of visual analytics in uncovering trends within complex datasets. The implications of these findings extend beyond the immediate research scope, influencing healthcare strategies and contributing to the ongoing discussions on innovative solutions for chronic disease management. This study contributes to the evolving field of visual analytics in healthcare, demonstrating the potential for such tools to inform decision-making and enhance patient outcomes
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    Risk factors for recurrent tuberculosis among HIV patients who are on anti-retroviral treatment in rural northeast, South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Kanzoole, Kingsley; Ibisomi , Latifat; Kabudula, Chodziwadziwa
    Background: Tuberculosis (TB) is a major public health concern, and according to the World Health Organization (WHO), is one of the top 10 causes of death worldwide. Recurrent TB is a significant contributor to the overall TB burden worldwide, particularly in areas where TB prevalence is high (4–6), and among HIV infected people. Aim: In this study, we investigated the risk-factors that are associated with the recurrence of TB among HIV infected people in rural northeast, South Africa. Methods: The study employed a retrospective cohort study design and used data from Agincourt health socio-demographic surveillance system spanning from 1st January 2014 to 31st December 2022. Data analysis was conducted using STATA 17 SE as the analytical tool. Cox regression was used to determine risk factors for recurrent TB among HIV patients on ART in rural northeast, South Africa. Results: The study included 4,803 participants with 1,326 (27.6%) males and 3,477 females (72.4%). The participants were predominantly of HIV WHO Stage 1 (84.7%), followed by Stage 2 (7.6%), then Stage 3 (7.0%) and Stage 4 (0.7). The age distribution had 24.8% aged 18-29, 34.5% aged 30-39, 23.1% aged 40-49, 11.0% aged 50-59 and 6.6% aged 60 and above. The study population had a CD4 count median of 229 cells/mm3 with an IQR of 112-390 cells/mm3 and a median duration of previous TB treatment of 31 weeks with an IQR of 16-49 weeks. Out of the 4,803 patients, 396 (8.2%) experienced recurrent TB. This translated to a recurrence rate of 3.0 per 100 person years. The median time to TB recurrence was 1.93 years, with approximately 50% experiencing the recurrence within this period. The significant risk factors associated with recurrent TB were being male (AHR=1.48, CI: 1.11 – 1.96), WHO HIV stage (AHR=2.53, CI: 1.81 – 3.54), baseline CD4 count (AHR=0.98, CI: 0.98 – 0.99), and duration of previous TB treatment (AHR=0.96, CI: 0.93 – 0.98). Conclusion: This study has identified significant risk factors for recurrent TB among HIV patients in rural northeast South Africa. Male patients have a higher risk, necessitating targeted interventions. Advanced HIV stages increase recurrence risk, emphasizing early diagnosis and management. Maintaining higher CD4 counts and continuous monitoring during and after TB treatment are vital to reducing recurrence. These findings inform strategies to improve health outcomes and control recurrent TB among HIV patients receiving ART in the region