3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Analysis of bronchoscopies performed at Chris Hani Baragwanath hospital between 2011–2018(2021) Ajayi, Adekunle OmoniyiBackground A definitive diagnosis of respiratory disease is often elusive without tissue biopsy. Bronchoscopy is a valuable procedure to both visualise and sample endobronchial lesions and lung parenchyma. Objectives We describe patient demographics, indications for, and diagnosis of, patients undergoing fibreoptic bronchoscopy at Chris Hani Baragwanath Academic Hospital (CHBAH) over an 8- year period (2011-2018). We also describe associations between demographic characteristics and diagnosis. Methods This is a retrospective record review of patients who had undergone fibreoptic bronchoscopy at CHBAH. Demographic, clinical and histopathological data were collected. Results Bronchoscopy records were retrieved for 830 patients. Two thirds of patients were male; the mean (SD) age of patients was 56.2 (13.3) years. Twenty-two percent of patients who had bronchoscopy were seropositive for HIV, with a median cluster of differentiation 4 (CD4) cell count of 233 cells/mm3 (IQR: 85-434). Bronchoscopies were performed mostly for suspected endobronchial lesions (52%) and pulmonary infiltrates (12%). Endobronchial biopsy was performed in half of patients undergoing bronchoscopy. The most common diagnosis was primary lung malignancy, found in 39% of patients. Squamous cell carcinoma was the commonest subtype (43%) and adenocarcinoma was diagnosed in 31%. Increasing age was significantly associated with a diagnosis of malignancy [OR 95% CI, 1.05 (1.04-1.06)] p<0.001. Women and HIV positive patients were less likely to be diagnosed with malignancy compared to men and HIV negative patients. Our study revealed that the complication rate during bronchoscopy was 2.16%. Conclusion In this retrospective study, flexible bronchoscopy was found to be a useful tool aiding the diagnosis of respiratory diseases and had a low complication rate. An endobronchial lesion was detected in 44% of the patients undergoing bronchoscopy and the commonest diagnosis was primary lung cancer.Item Knowledge of cervical cancer, Human Papilloma Virus (HPV) and HPV vaccination among primary health care workers in the Mamusa and Naledi sub districs(2017) Ajayi, Adekunle OmoniyiIntroduction: Cervical cancer is a very common female cancer; with up to 524,000 cases being diagnosed annually worldwide.1 Human papilloma virus (HPV) has long been established as the causative factor in the development of cervical cancer.2, 3 HPV vaccination has been found to drastically reduce the development of cervical cancer especially if administered to young people before their sexual debut. This study was to assess the knowledge of primary health care workers in the Mamusa and Naledi sub-districts in the North West Province about cervical cancer, HPV and the HPV vaccine. Methods: This was a descriptive cross-sectional study done with 116 primary health care workers using a self-administered questionnaire that was derived from a duet of questionnaires previously used in Poland and Australia. Adequate knowledge of cervical cancer and HPV vaccination meant getting 70% of the questions asked on the subject correctly while a threshold of 80% was used for adequate knowledge of HPV vaccination. All categories of primary health workers were included in the study asides from pharmacists who were excluded. Descriptive statistics, tests of association and logistic regression analysis was used in the study. The survey was done between September to November 2016 following ethics approval from the University of Witwatersrand. Results: 116 participants were involved in this study. The majority were black female professional nurses with diplomas. The mean age of the participants was 36.6 ± 8.7 years. Only 26% of the respondents had adequate knowledge of cervical cancer. 41% of respondents had adequate knowledge of HPV, while 67% of respondents had adequate knowledge about HPV vaccination. In our study, we found a significant association between knowledge of HPV and the health care worker category (p < 0.001). There was a significant association between knowledge of HPV vaccination and the highest educational level that was attained by the respondents (p= 0.010). Conclusion: Primary health care workers form an integral part in the fight against cervical cancer. Significant gaps still exist in the level of knowledge of health care workers, particularly in relation to cervical cancer and HPV. Improved learning and training opportunities for primary health care workers can help correct the knowledge deficit