3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Patient attendance at Soweto dental clinics before and after introduction of free dental services(2014-03-10) Bhayat, AhmedKnowledge of how attendance loads at dental clinics have changed since free dental services were introduced in April 1996 is vital for the proper implementation of services. The objective of this study was to compare monthly attendances in Soweto dental clinics one year before and one year after the introduction of free dental treatment. Details of the total number of attendances, casual and booked, at all ten dental clinics in Soweto were noted from the central records at Lillian Ngoyi clinic, as well as the number of operators. These data were stored in the Wits computer network for analysis with SAS and Prism3 computer software. A patient attendance index was defined as the number of attendances per clinic corrected for the number of operators. Patient attendance fluctuated by day and season throughout the study period. There was a mean 46% increase in patient attendance when the years before and after free treatment were compared. Casval patient attendance [pain and sepsis treatment] increased by a mean of 52% and booked attendance [restorative treatment] increased by 8%.There was a mean increase of 19% in the patient to operator ratio. Casual patient attendance has increased the workload on operators and has kept the booked attendance at a low level. Furthermore, the preventive school programmes can no longer be maintained as a result of the staff workload. This could have serious consequences for the future generations and operators alike.Item Predictive value of group I oral lesions in detecting HIV infection amongst patients attending PHC facilities in Gauteng(2008-05-15T11:30:47Z) Bhayat, AhmedAbstract The utilization of oral lesions as a screening tool for HIV is not well documented. Attendees at two primary health care facilities (Khutsong and Heidelberg) were assessed to determine the predictive value of group I oral lesions for HIV infection. The objectives were to investigate the: 1) HIV prevalence amongst attendees at PHC facilities, 2) Prevalence of HIV-related oral lesions and 3) Correlation between the oral lesions and the HIV status using the Likelihood Ratio test. Methods: All patients over 12 months of age presenting at the two facilities for a curative care consultation over a one-week period (in April 2005) were included. Consent was obtained by trained counselors who also conducted a brief interview and offered pre-test counseling to patients wishing to know their HIV status. Two calibrated dentists conducted a head, neck and oral examination and administered a rapid saliva HIV test (OraQuick HIV-1/2-Rapid HIV-1/2 Antibody Test). Results: A total of 654 attendees were surveyed in the 2 facilities. There was a 100% response. The mean age of the participants was 34 years (range: 1-94), and the majority (73%) were female. HIV prevalence rates were 34% at Khutsong and 36% at Heidelberg. The HIV prevalence peaked at 46% in the 16-45 age groups. Of the 228 who tested positive for HIV, 121 (53%) patients were diagnosed with 1 or more Group I oral lesion. Oral candidiasis (46%) and oral hairy leukoplakia (19%) were the two most common oral lesions diagnosed in the HIV positive cohort. The positive predictive values and specificity values for multiple lesions ranged between 96% and 100%. Most of the likelihood ratios for multiple lesions were greater than 10 which implied that the patients who presented with these lesions were extremely likely to test positive for HIV. The sensitivity values (1% to 37%) and negative predictive values (66% to 70%) remained relatively low. Conclusion: The HIV prevalence of patients attending PHC facilities was high (34%). Oral lesions are useful markers of HIV-infection and should alert clinicians to the presence of HIV infection. Multiple group I lesions were more predictive of HIV infection compared to single lesions.Item Attitudes of oral hygiene and dental therapy students regarding the introduction of community service.(2007-02-23T11:44:20Z) Bhayat, AhmedIntroduction: Compulsory Community Service (CS) for health professionals has been introduced in South Africa since 1997. Some of the aims for its introduction were to: 1) address the maldistribution of health service providers, 2) prevent qualified health professionals from emigrating and 3) improve clinical skills and knowledge of newly qualified medical graduates. The Oral Hygiene (OH) and Dental Therapy (DT) professions have as yet not been included in the performance of CS. However the Department of Health (DOH) is planning to introduce CS for these groups of health professionals in the near future. The role of the oral hygienist and dental therapist in South Africa (SA) cannot be over emphasized. Given the high caries levels, low oral hygiene education levels, large unmet oral health needs and the preventative approach of the DOH at all levels, the oral hygienist and dental therapist can provide invaluable human and technical resources that are currently required to address these concerns. Aims: To assess the attitudes of OH and DT students registered during 2004 at the five dental schools in South Africa regarding the introduction of CS. Objectives: 1) To obtain the demographic data of the OH and DT students, 2) to determine whether their current training programme prepares these students for CS, 3) to identify the provinces in which the OH and DT students would prefer to be placed for CS and 5) to identify the different types of professional activities that the OH and DT students would like to perform whilst completing CS. Methods: A self administered questionnaire was jointly developed between the Kwa- Zulu Natal Department of Health and the Division of Public Oral Health at the University of Witwatersrand, Johannesburg. The questionnaire was sent to all OH and DT students who were registered at each of the five dental schools in SA during 2004. Results: There were a total of 163 students (68%) who responded to the questionnaire. Of the respondents, 109 (70%) were OH students and 54 (64%) were DT students. There were 132 (81%) females and 31 (19%) males. The average age of the student’s was 21 years (17-37; mode 19; median 20 and SD 3.2). There were 59 (36%) Whites, 53 (33%) Black, 31(19%) Asian and 18 (11%) Coloured students. The majority of OH students (63%) were against the introduction of CS. There was a significant number (p<0.05) of White students who were registered for the OH degree that did not want to perform CS. A significant number of respondents (p<0.05) felt that they were adequately trained to perform all the necessary duties that may be required of them during their CS. Most of the respondents chose Kwa-Zulu Natal (26%), Western Cape (26%) and Gauteng (22%) provinces respectively as their first choice province for carrying out their CS. The majority of students (p<0.05) chose their resident province as their first choice province in which they would prefer to perform their CS. Students indicated a preference to perform oral health promotional activities (56%), health educational activities (21%) and clinical work (18%) in their CS programme. Conclusion: The majority of DT students supported the concept of CS. This was in contrast to the OH students where less than half of them supported its introduction. Overall, most of the students chose the more urban provinces (Kwa-Zulu Natal, Western Cape and Gauteng) to complete their CS.