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Recent Submissions

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The Relationship Between Sensory Disability Status and Contraceptive Use Among Women Aged 15- 49 Years Old In South Africa
(University of the Witwatersrand, Johannesburg, 2024) Sifora, Kutlwano Katlego Kimberly; De Wet-Billings, Nicole
Background: Studies suggest that disability significantly hinders access to reproductive health services, particularly family planning, in low- and middle-income countries. Women with disabilities have a low contraceptive use rate, leading to increased risks of unintended pregnancies and health complications. This study examined the relationship between sensory disability status and contraceptive use in South Africa. A sensory disability is a condition that affects one or more of the body's sensory functions like sight, hearing, touch, taste, or smell. In this study, sensory disabilities focused on hearing and visual impairments. Methods: The study employed a cross-sectional design using the 2016 South Africa Demographic and Health Survey. The study focused on women of reproductive age (15–49 years old) in South Africa, who were sexually active and provided information on both their contraceptive use and sensory disability status. The outcome variable of this study was contraceptive use, and the main independent variable was sensory disability status. The control variables included demographic characteristics namely age, race, marital status, province, and place of residence, as well as socioeconomic characteristics such as employment status, wealth status, education, family planning messages, and contraceptive knowledge. The analysis was conducted using Stata 17.0 on a weighted sample of 6 683 sexually active women aged 15–49 years old who answered questions on contraceptive use. The data analysis was done in three phases. For the first phase, cross-tabulations and chi-square analysis were used to demonstrate the levels of contraceptive use as well as all characteristics of women. For the second phase, bivariate binary logistic regression models were used to determine the relationship between each of the independent variables and the outcome variable of contraceptive use. Lastly, for the third phase, a stepwise multivariate binary logistic regression was utilised to determine the relationship between sensory disability status and contraceptive use among women aged 15– 49 years old in South Africa. Results: Among South African women of reproductive age, 55.4% were using contraceptives. Women with sensory disabilities were shown to have lower odds of using contraceptives than those without sensory disabilities, even after adjusting for all other variables [OR: 0.78, CI: 0.63873 - 0.95227]. Significant associations with contraceptive use were observed for factors xi including age, race, marital status, education and province. Compared to women aged 15–24, women aged 35–39 had a much lower likelihood of using contraceptives. [OR: 0.46, CI: 0.38150 - 0.55364]. Women from races other than black were also observed to have lower odds for contraceptive use compared to black women [OR: 0.75, CI: 0.61098 - 0.92237]. Conversely, married women were significantly more likely to use contraceptives than women who were never married [OR: 1.23, CI: 1.05328 - 1.42899]. Additionally, women with secondary [OR: 1.98, CI: 1.28089 - 3.07512] or higher education [OR: 2.40, CI: 1.49931 - 3.83750] exhibited a significantly higher likelihood of contraceptive usage compared to those lacking formal education. Women residing in Western Cape [OR: 1.83, CI: 1.29743 - 2.57637], Eastern Cape [OR: 1.66, CI: 1.27747 - 2.15886], Northern Cape [OR: 1.61, CI: 1.18574 - 2.19087], KwaZulu Natal [OR: 1.51, CI: 1.17797 - 1.92456], North West [OR: 1.43, CI: 1.01266 - 2.01228], and Mpumalanga [OR: 1.50, CI: .15808 - 1.93439] were found to have a higher likelihood of using contraceptives compared to women residing in Limpopo. Conclusions: Low contraceptive use among women with sensory disabilities in South Africa highlights the need for inclusive reproductive health services, addressing communication, information access, and societal attitudes to ensure informed decisions.
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The Mental Health Needs of South African Mainstream High School Learners: Teachers’ Experiences and Perceptions
(University of the Witwatersrand, Johannesburg, 2023) Abreu, Leandra Imilia; Amod, Zaytoon
This qualitative study set out to explore teachers’ experiences and perceptions of South African high school learner mental health. Mainly, what teachers believe to contribute towards learner mental health, what they deem to be the barriers and how they believe these barriers can be addressed. The study aimed to provide insight into facilitative factors and challenges concerning adolescent learner mental health in addition to offering support to teachers in managing the mental health of their learners, an important factor in assisting the overall development of South African learners. To better understand these views, twelve qualified and registered teachers practicing in South African high schools were interviewed using a non-probability, purposive sampling technique and following an interpretive phenomenological approach. The use of semi-structured individual interview questions was used to ascertain the perceptions and experiences of 12 teachers in South Africa. The teachers were approached via online platforms, due to social restrictions during the COVID-19 pandemic. The data was analysed using Braun and Clarke's (2006) thematic analysis to establish the main themes brought up by the participants. The findings uncovered numerous themes and subthemes surrounding teachers’ perceptions of aspects contributing to the mental health of their learners namely: challenging households and the role of parents, social pressures and stressors, anxiety, depression, ADHD and the influence of self-esteem. The impacts of COVID-19 were also prominent due to the interviews being conducted during the initial lockdown period in South Africa. The teachers identified a lack of resources and teacher mental health training/knowledge, stigma and poverty as three of the major barriers to learners accessing mental health support. Finally, the teachers identified multilayered responsibilities, interventions pertaining to teacher training and curriculum adaptions as possible approaches to address these barriers. These findings suggest that managing the mental health of learners is extremely burdensome for teachers who feel unsupported. Obtaining teachers’ perceptions, experiences and beliefs about learner mental health is thus important to improve school psychological services. The findings contribute to research regarding factors influencing learner mental health and adds to the limited empirical research available surrounding South African teachers’ experiences and perceptions. It is recommended that future research be carried out on several different aspects surrounding adolescent mental health in South Africa.
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Post-COVID Syndrome in Otorhinolaryngology: A Systematic Review
(University of the Witwatersrand, Johannesburg, 2023-07) Chiware, Rumbidzai; Maharaj, Shivesh
Background: The novel virus SARS-CoV-2 which is the cause for coronavirus-19 disease (widely known as COVID-19), has shifted health and healthcare worldwide. With the majority of COVID-19 cases having mild to moderate symptoms, and with improvement in treatment and survival of severe disease, there has been a rise in the number of patients presenting with prolonged, recurrent or new symptoms long after the time frame of active disease. This phenomenon has been given various terms which include post-COVID syndrome. Post-COVID syndrome like acute disease has various clinical presentations that involve multiple systems in the body which include the ear, nose and throat. Due to the substantial increase in this population of patients with ongoing COVID-19 symptoms, the current focus is towards identifying and managing these patients early so as to improve outcomes and quality of life. Objectives: The aim of this systematic review was to bring awareness to post-COVID syndrome in the context of otorhinolaryngology with a description of the demographics, clinical manifestations and identifiable predisposing factors. The secondary objectives were to describe special investigations used for diagnosis and management of patients with post-COVID syndrome in otorhinolaryngology. Methods: A systematic review of all the available published literature (systematic reviews, cohort studies, case series and case studies) was conducted. The databases searched were PubMed, The Cochrane Database of Systematic Reviews, EMBASE, and Google Scholar. The search terms used were “post-COVID syndrome” OR ‘’post-acute COVID-19’’ OR ‘’long COVID’’ AND “chemoreceptor dysfunction” OR “Otology” OR “Rhinology” OR “Laryngology”. The search included articles from January the 1st 2020 to the 31st of July 2021. A total number of 13 561 articles were found of which 25 articles met the inclusion criteria. The systematic review was a retrospective study of information already available in the public domain. Ethics clearance was received from the University of the Witwatersrand Human Research Ethics Committee (medical). Results: A total of 25 studies were included in the systematic review with a total of 1041 patients presenting with otorhinolaryngological symptoms associated with COVID-19. Patients who presented with symptoms in the post-acute COVID-19 period (more than 4 weeks) were 383 in total. The vast majority presented with chemosensory dysfunction (olfactory +/- gustatory) accounting for 82,5% (n=316). Patients with audiovestibular symptoms (sensorineural hearing loss, tinnitus and/or vertigo) accounted for 7,6% (n=29) and patients with dysphonia 9,9% (n=38). Fifteen percent of cases (152/1041) presented with otorhinolaryngological symptoms beyond 12 weeks (post-COVID syndrome). Chemosensory dysfunction still accounted for most cases in this group with 80,9% (n=123), 8,6% (n=13) had persistent or residual audiovestibular symptoms (sensorineural hearing loss, tinnitus, vertigo) and 10,5% (n=16) had persistent dysphonia. The limitations of the systematic review were the lack of high-quality data due to the novelty of COVID-19, the risk of bias of individual studies and the heterogenous findings and outcomes. Conclusion: Post-COVID syndrome like acute COVID-19 manifests in multiple systems in the body which include the ear, nose and throat. Otorhinolaryngological symptoms that this population presents with include chemosensory dysfunction, audiovestibular dysfunction and dysphonia. Olfactory dysfunction is the dominant presentation with more data available in the literature as it presents more commonly. There is need for larger and more detailed future studies with focus on identification of specific risk factors that predispose individuals to post-COVID syndrome with the goal of improving outcomes and preventing long-term disability.
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The role of prophylactic antibiotics in zone II and zone V acute flexor tendon injury
(University of the Witwatersrand, Johannesburg, 2023-11) Tshisikule, Rihangwele Christopher; Sathekga, Mokgopo Cynthia; Sekeitto, Allan Roy
Background: In the literature, there is no universal consensus on the role of antibiotic prophylaxis in patients presenting with simple hand lacerations that has no macroscopic wound contamination. Our study sought to establish the necessity of prolonged pre-operative antibiotic prophylaxis in patients presenting with zone II and zone V acute flexor tendon injuries (FTI) at Chris Hani Baragwanath Academic Hospital (CHBAH). Methods: This was a prospective study of 116 patients who presented with zone II and zone V acute FTI. The study period was between 01 November 2020 and 31 August 2021. Patients were randomised into a group receiving a single dose of prophylactic antibiotic in casualty and another group receiving a single antibiotic dose plus a continuous 8 hourly dose until the day of surgery. Each group was subdivided into occupational and non-occupational injuries. Their post-operative wound outcomes were documented 10 ‒ 14 days after surgery. The wound outcome was reported as no infection, superficial infection (treated with wound dressings), and deep infection (requiring surgical debridement). Results: There was 0.9% rate of deep post-operative wound infections, which was a single zone V acute FTI case in a single dose prophylactic antibiotic group. There was a 7.8% superficial post-operative wound infection rate, which was mainly zone II acute FTI in both antibiotic groups. There was a strong association between zone II acute FTI and post-operative wound infection (p < 0.05). There was no association between (antibiotic dosage or place of injury) with post-operative wound infection (p > 0.05). Conclusion: There is no benefit in prescribing prolonged pre-operative antibiotic in patients with acute, simple lacerations to zone II and zone V FTI if there is no macroscopic wound contamination.