School of Clinical Medicine (ETDs)

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Browsing School of Clinical Medicine (ETDs) by Keyword "Africa"

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    Attitudes and perceptions of caregivers regarding their presence at induction of anaesthesia
    (University of the Witwatersrand, Johannesburg, 2021) Le Roux, Johannes Jacobus; Redelinghuys, Cara
    Background Caregiver presence at their children’s induction of anaesthesia is practiced daily around the world. International studies demonstrated conflicting emotions in caregivers present at induction of anesthesia of their children. These positive and negative emotions ranged from comforting and reassuring, to traumatising and disturbing. Research exploring the attitudes and perceptions of caregivers regarding this practice is limited within the African context. Aims The aim of this study was to describe caregivers’ attitudes and perceptions regarding their presence at induction of their children’s anaesthesia. Methods This descriptive, phenomenological, qualitative study was conducted in 2020 at Chris Hani Baragwanath Academic Hospital, a 3200-bed facility in South Africa. Twenty caregivers of children (aged 2 to 8 years) undergoing elective surgery were recruited. Data was collected through face-to-face, in-depth, semi-structured individual interviews using purposive sampling. Interviews ranged between 11 and 55 minutes in duration and were conducted within 24 hours of induction of anaesthesia. The audio recorded interviews were transcribed and subjected to inductive reflexive thematic analysis. Results Six themes were developed: Fulfilment of caregiver role, A positive experience, A traumatic experience, Not prepared for the experience, My world is my reality, and Your world is a place different to mine. Conclusion A caregiver’s perception of the induction process is influenced by multiple factors. A finding specific to our cohort is the interplay between complex multifaceted cultural beliefs and anaesthesia of their children. By acknowledging and addressing these beliefs, a caregiver’s presence can be tailored to ensure a positive experience for all involved at induction
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    Comorbidities in a cohort of privately insured South Africans with systemic lupus erythematosus
    (2024) Ntumba, Mbombo Henriette Ngandu
    Background: Comorbidities in systemic lupus erythematosus (SLE) impact negatively health related quality of life and life expectancy. We undertook a retrospective study of the burden of comorbidities in privately insured South Africans with SLE. Methods: Data review of patients insured with Discovery Health Medical Scheme (DHMS), ≥16years at diagnosis, ≥6months follow-up and diagnosed with SLE based on ICD 10 codes. Demographics, drug therapy and comorbidities listed in the Charlson Comorbidity Index (CCI) and other comorbidities occurring commonly in SLE patients were documented. Results: Of 520 patients with SLE ICD 10 codes, only 207 met the other inclusion/exclusion criteria for data analysis. Most were women (90.8%), median (IQR) age and follow-up duration of 39 (30.3-53.0) and 6.1 (3.7-8.1) years, respectively. All patients had at least one comorbidity, the most frequent CCI comorbidities being pulmonary disease (30.9%), congestive heart failure (CHF) (15%) and renal disease (14.5%). Common CCI comorbidities were hypertension (53.1%), mood and anxiety disorders (46.9%), infections (urinary tract infections (UTI) (37.7%) and pneumonia (33.8%)). Independent predictors of 1) CHF were renal disease (OR=855), dyslipidaemia (OR=15.3) and male gender (OR=43.0); 2) hypertension were age at diagnosis (OR=1.03), type 2 diabetes (OR=4.45) and renal disease (OR=4.34); and 3) mood and anxiety disorders were female gender (OR=3.98), cerebrovascular accident (OR=3.18), UTI (OR=2.39) and chloroquine use (OR=1.94). Conclusion: Comorbidities in this cohort of privately insured South Africans with SLE were common, with all patients having at least one comorbidity. Hypertension, infections and mood and anxiety disorders were the leading comorbidities.